CAJ | 학술논문

目的：应用定量CT（ QCT）测定腰椎骨密度，探讨骨质疏松性脊柱骨折不同类型间的椎体体积骨密度是否存在差异。方法以因腰椎骨折来北京积水潭医院进行腰椎QCT检查的77例绝经后女性患者为研究对象，所有患者均为脆性骨折，且骨折仅累及一个腰椎椎体，年龄55－85岁，平均71±7．84岁。 QCT测量L1－4中未骨折椎体的骨密度值，并计算每位患者L1－4未骨折椎体的骨密度均值。根据脊柱CT扫描矢状重建的图像将椎体骨折类型分为楔形、双凹及挤压三种类型。使用两组独立样本的t检验比较楔形与双凹骨折组间的骨密度是否存在差异。使用两组独立样本的t检验比较楔形与双凹骨折组间的年龄是否存在差异。结果楔形（年龄均值70．26±7．99岁）和双凹（年龄均值70．92±7．80岁）骨折组间的年龄差异没有统计学意义（t＝－0．347，P＝0．730），可以基本排除年龄因素的干扰。楔形和双凹骨折组间的骨密度差异有统计学意义（t＝2．254，P＝0．028）；双凹组（组均值32．08 mg／cm3）骨密度较楔形组（组均值45．05 mg／cm3）低。结论骨质疏松性脊柱骨折的类型与椎体体积骨密度可能存在一定的相关性，双凹形骨折可能比楔形骨折的骨密度低。
목적：응용정량CT（ QCT）측정요추골밀도，탐토골질소송성척주골절불동류형간적추체체적골밀도시부존재차이。방법이인요추골절래북경적수담의원진행요추QCT검사적77례절경후녀성환자위연구대상，소유환자균위취성골절，차골절부루급일개요추추체，년령55－85세，평균71±7．84세。 QCT측량L1－4중미골절추체적골밀도치，병계산매위환자L1－4미골절추체적골밀도균치。근거척주CT소묘시상중건적도상장추체골절류형분위설형、쌍요급제압삼충류형。사용량조독립양본적t검험비교설형여쌍요골절조간적골밀도시부존재차이。사용량조독립양본적t검험비교설형여쌍요골절조간적년령시부존재차이。결과설형（년령균치70．26±7．99세）화쌍요（년령균치70．92±7．80세）골절조간적년령차이몰유통계학의의（t＝－0．347，P＝0．730），가이기본배제년령인소적간우。설형화쌍요골절조간적골밀도차이유통계학의의（t＝2．254，P＝0．028）；쌍요조（조균치32．08 mg／cm3）골밀도교설형조（조균치45．05 mg／cm3）저。결론골질소송성척주골절적류형여추체체적골밀도가능존재일정적상관성，쌍요형골절가능비설형골절적골밀도저。
Objective To evaluate if the difference exists between the different types of osteoporotic vertebral fractures and the vertebral volumetric bone mineral density ( BMD) detected using quantitative computed tomography ( QCT) .Methods The QCT BMD was obtained from a cohort of 77 postmenopausal female patients with lumbar fracture ( aging from 55 to 85 years, mean age 71 ±7.84 years) .All the fractures were fragile ones.Patients with only one lumbar vertebral body fracture were involved.BMD of the non-fractured vertebrae was measured and calculated using QCT.The fractures were divided to wedge, biconcave, and crush type according to the saggital CT image.Independent-samples t test was used to evaluate the difference of BMD and age between wedge and biconcave type of fractures.Results The difference in age between wedge ( mean age 70.26 ±7.99 years ) and biconcave (mean age 70.92 ±7.80 years) fracture was not statistically significant (t=-0.347, P=0.730), therefore excluding the interference of age factor.There was statistically significant difference between wedge and biconcave fractures ( t=2.254,P=0.028) .BMD in group of biconcave fracture ( mean 32.08 mg/cm3 ) was lower than that of wedge fracture ( mean 45.05 mg/cm3 ) .Conclusion There may be correlation between type of osteoporotic lumbar fractures and BMD.BMD in biconcave fractures may be higher than that in wedge fractures.