跟骨超声骨质测量与双能量X线吸收骨密度测量的比较

Comparison of calcaneal bone mass measurement by ultrasound and bone mineral density by dual energy X-ray absorptiometry

我们试图通过对跟骨超声骨质测量仪与双能量Ｘ线吸收骨密度测量仪的临床对比，来评价跟骨超声骨质测量仪的敏感性。本文对５６名健康女性同时接受了超声骨质测量仪和双能量Ｘ线吸收骨密度仪的检测。３７例（年龄２６～７６岁）进行了跟骨超声和腰椎骨密度测量，１９例（年龄２６～７０岁）进行了跟骨超声和股骨颈骨密度测量。结果用ＳＹＳＴＡＴ统计软件包进行处理。结果表明：随着年龄的增加，腰椎、股骨颈骨密度及跟骨强度（Ｓｔｉｆｆｎｅｓｓ）均显著下降（Ｐ＜０．０５），两种仪器的阳性检出率无明显差异（Ｐ＜０．０５）。但腰椎和股骨颈ＢＭＤ与跟骨强度（Ｓｔｉｆｆｎｅｓｓ）的相关性适中ｒ＝０．４６５～０．５１３左右。通过逐步多元回归分析显示超声强度（Ｓｔｉｆｆｎｅｓｓ）与ＢＭＤ无关。这表明超声波测量仪主要测量骨的结构变化，而骨密度测量仪则是测量骨量的变化。两种方法相辅相承，共同测量，将更好地预测骨质疏松性骨折的发生。同时超声波具有无放射线损害、价格低廉及良好的敏感性，将越来越受到临床重视。

We evaluated the sensitivity of ultrasound in measuring bone mass of calcaneal bone by comparing with dual energy x-ray absorptiometry.Measurements of stiffness, which come from ultrasonic transmission velocity(UTV) and broadband ultrasonic attenuation(BUA), were made at the os calcis using a Lunar Achilles ultrasound device. Measurements of bone mineral density of lumbar spines (L2-L4) and femoral neck were made using dual energy x-ray absorptiometry(DEXA). 37 healthy women (age 26-76) were measured for calcaneus stiffness and lumbar spine BMD. 19 healthy women (age 26-70)were measured for calcaneus stiffness and femoral neck BMD. All results were analysed by SYSTAT statistical software.The results showed that as age increased, lumber BMD, femoral neck BMD and heel bone stiffness significantly decreased (P<0.05 ). There was no statistically significant difference between ultrasound and DEXA findings in osteoporsis positive rate (P>0.05), but there was correlation between BMD and stiffness (γ=0.465-0.513). Bone mineral density was not related to ultrasonic stiffness by multiple regression analysis.Calcaneus ultrasound is used mainly for determining change in bone structure and DEXA mainly for determining change in bone mass. It had better to forecast fracture due to osteoporosis by the two methods simultaneously. Ultrasound causes no radiation-induced injury, entails low cost, has good sensitivity and is paid increasing attention by clinicians.