CAJ | 학술논문

目的：探讨定量CT （QCT）测量成年男性强直性脊柱炎（AS）患者髋臼骨密度（BMD）的价值，研究此类患者髋臼骨量变化。方法选取25例经临床确诊的成年男性AS患者为志愿者，年龄20～44岁，平均（28.6±7.1）岁。分别行双侧髋关节（50个）双能X线吸收仪（DXA）和QCT检查。按照全髋部DXA测定结果，将Z值≤－2.0 S的27个髋关节设为试验组， Z值＞－2.0 S的23个髋关节设为对照组，比较2组髋臼坐骨体、耻骨体和髂骨体BMD的差异。结果试验组耻骨体、坐骨体BMD值分别为（71.965±35.695）、（87.093±38.413） mg／cm3，显著低于对照组的（110.526±62.466）、（121.883±39.380） mg／cm3，差异有统计学意义（P＜0.05），试验组髂骨体BMD （156.822±41.472） mg／cm3与对照组（177.948±55.804） mg／cm3差异无统计学意义（ P＞0.05）； AS患者髋臼髂骨体BMD均显著高于坐骨体和耻骨体BMD （均P＜0.05）； AS患者坐骨体和耻骨体 BMD 差异无统计学意义（ P＞0.05）。结论QCT可敏感地反映髋臼不同部位BMD变化。 AS患者髋臼的坐骨体、耻骨体较髂骨体更易出现骨密度减低。
목적：탐토정량CT （QCT）측량성년남성강직성척주염（AS）환자관구골밀도（BMD）적개치，연구차류환자관구골량변화。방법선취25례경림상학진적성년남성AS환자위지원자，년령20～44세，평균（28.6±7.1）세。분별행쌍측관관절（50개）쌍능X선흡수의（DXA）화QCT검사。안조전관부DXA측정결과，장Z치≤－2.0 S적27개관관절설위시험조， Z치＞－2.0 S적23개관관절설위대조조，비교2조관구좌골체、치골체화가골체BMD적차이。결과시험조치골체、좌골체BMD치분별위（71.965±35.695）、（87.093±38.413） mg／cm3，현저저우대조조적（110.526±62.466）、（121.883±39.380） mg／cm3，차이유통계학의의（P＜0.05），시험조가골체BMD （156.822±41.472） mg／cm3여대조조（177.948±55.804） mg／cm3차이무통계학의의（ P＞0.05）； AS환자관구가골체BMD균현저고우좌골체화치골체BMD （균P＜0.05）； AS환자좌골체화치골체 BMD 차이무통계학의의（ P＞0.05）。결론QCT가민감지반영관구불동부위BMD변화。 AS환자관구적좌골체、치골체교가골체경역출현골밀도감저。
Objective To evaluate the QCT in measuring acetabular BMD of the adult male with ankylo-sing spondylitis, and to study the change of acetabular metabolism of these patients .Methods Twenty-five adult male patients ( range 20-44 years, mean age, 28.6 ±7.1 years) with AS by clinical confirmed were underwent DXA and QCT in bilateral hip, separately.According the BMD results of total hip on DXA, twenty-seven hip Z-score of -2.0 or below as experimental group, and twenty-three totl hip Z-score as control group.Then we compare the difference of BMD in ischium, pubic and ilium between the two groups.Results The BMD in ischium and pubic of experimental group [ (87.093 ±38.413) and (71.956 ±35.695) mg/cm3] was lower than that in control group [ (121.883 ±39.380) and (110.526 ±62.466) mg/cm3], with significant difference (P<0.05).However, no significant difference of BMD was found in ilium between the experimental group [ (156.822 ±41.472) mg/cm3 ] and control group [(177.948 ±55.804) mg/cm3] (P >0.05).The BMD in ischium and pubic of both groups was signifi-cantly higher than that in ilium (P<0.05).There was no significant difference of BMD in ischium and pubic of both groups ( P>0.05 ) .Conclusion QCT can be used to test the change of BMD in acetabulum sensitively .The ischium and pubic of acetabulum in patients with AS was vulnerable to osteopenia .