骨折患者胫骨定量超声骨量及骨折阈值的测定

Quantitative ultrasound measurement of tibia and threshold of fracture in fractured patients

目的确定太原地区健康人群胫骨定量超声骨量（ＱＵＳ）的正常参考值范围，探讨用ＱＵＳ诊断骨质疏松的诊断标准及骨折阈值的界限。方法：对２６７２例７～９２岁居住在太原地区的健康人群和１０５例４６～９１岁的骨折患者，采用定量超声骨量分析仪测定胫骨ＱＵＳ值。结果：健康人群胫骨ＱＵＳ值在３０岁以前随年龄的增加而增加；峰值在３０～３９岁，男性５０岁以后胫骨ＱＵＳ值均匀下降；女性４０岁以后胫骨ＱＵＳ值开始下降，胫骨ＱＵＳ值与绝经时间呈负相关性（Ｐ＜０．０１）；以２０～４０岁男性及女性胫骨ＱＵＳ均值减２．０及２．５标准差，分别得出各自的界限值（３６９４．８３７ｍ／ｓ和３６６７．２４３ｍ／ｓ），６３例女性骨折患者中５９例（９３．７％）及４２例男性骨折患者中４０例（９０．５％）胫骨ＱＵＳ低于此界限值。结论：２．０标准差胫骨ＱＵＳ界限值可作为男性和女性骨质疏松症的诊断标准；２．５标准差ＱＵＳ界限值可作为男性和女性骨质疏松症的骨折危险阈值。

Objective\ To define normal reference range of quantitive ultrasound (QUS) in normal people and probe into the diagnostic criterion and fracture threshold for osteoporotic patients by QUS.Methods QUS of tibia was measured in 2672 nomal people aged 7 92 and 105 fractured patients aged 46 91 in Taiyuan area.Results In normal people,QUS increased before the age of 30,peaked at the age of 30 39,and decreased after the age of 50 in men and after the age of 40 in women.There was negative correlation between QUS and duration of menopause ( P <0 01).Taking the mean QUS of young males and females aged 20 40 years minus 2.0 and 2.5 s (3694.837 m/s and 3667.243m/s) as cut off values,QUS of 59 in 63 fractured females (93.7%) and 40 in 42 fractured males (90.5%) was lower than cut off values.Conclusions The cut off value of mean QUS minus 2.0 s may be used as diagnostic criterion of osteoporosis and mean QUS minus 2.5 s as the fracture threshold risk for men and women.