511例广州地区中老年女性骨密度结果分析

Bone Mass Density of Middle-aged and Senile Women in Guangzhou City: An Analysis of 511 Cases

[目的]探讨广州地区中老年妇女全身及腰椎骨密度的变化规律,确定其骨质疏松的高危因素。[方法]统计2000年1月至2003年12月间,在广东省人民医院骨质疏松防治中心就医的511例中老年妇女各年龄组骨密度值及骨质疏松症的发病情况,分析年龄、身高、体质量和体质量指数(体质量和身高的比值)以及绝经与骨密度的关系。[结果]全身骨密度、腰椎正位和腰椎侧位的骨密度与年龄均呈负相关(P<0.01),而与身高和体质量呈正相关(P<0.01和P<0.05),与体质量指数无显著相关性(P>0.05);骨密度在35-39岁达到峰值[(1.09±0.07)g/cm2],40岁以后随年龄的增加而降低,骨质疏松的发生率也逐渐增高,55岁以后骨质疏松检出率大幅增多,70岁以后全身骨密度测定的骨质疏松检出率超过70%;50岁以前,绝经后期的全身骨密度、正腰骨密度和侧腰骨密度均比围绝经期低(P<0.05或P<0.01),50岁开始,虽然围绝经期的全身骨密度和正腰骨密度已降低到接近绝经后期水平(P>0.05),但侧腰骨密度仍然高于绝经后期(P<0.01);而总体围绝经期的骨密度与正常人比较无显著性差异(P>0.05)。[结论]高龄、身材矮小和低体质量是妇女骨质疏松症的危险因素;绝经后妇女是骨质疏松的高危人群,绝经后就要开始防范,以减少骨质疏松及骨折的发生;腰椎侧位骨密度检测是早期诊断Ⅰ型骨质疏松症的敏感部位。

[Objective] The changes of general and lumbar spinal bone mass density (BMD) were analyzed to explore the risk factors of osteoporosis (OP) . [Methods] BMD and incidence of osteoporosis were investigated in 511 cases admitted by Osteoporosis Prevention & Treatment Center of Guangdong Provincial People's Hospital from January of 2000 to December of 2003. The relationship of BMD with age, body height, body weight, body weight index (ratio of body weight and body height) and menopause was analyzed. [Results] BMD of general body, lumbar frontal position and lumbar lateral position was negatively correlated with the age (P < 0.01) , positively correlated with the body height and weight (P < 0.01 or P < 0.05), not correlated with body weight index (P > 0.05). BMD arrived to the peak of 1.09±0.07 g/cm2 at the age of 35 - 39 and decreased with the age over 40, and the incidence of osteoporosis increased correspondingly . The detectable rate of osteoporosis remarkably increased in cases aged 55 years and older, and was over 70% in cases aged 70 years and older. In cases under 50 years old, postmenopausal BMD of general body, lumbar frontal position and lumbar lateral position was lower than that in perimenopausal period ( P < 0.01 or P < 0.05) , while in those over 50, perimenopausal BMD of general body and lumbar frontal position decreased and arrived to postmenopausal level (P > 0.05), but that of lumbar lateral position still was higher (P < 0.01), the difference of perimenopausal BMD being insignificant as compared with the normal volunteers (P > 0.05) . [Conclusion] Advanced age, shorter height and lower body weight are the risk factors of osteoporosis. Postmenopausal women are the risk population of osteoporosis, and preventive measures should be taken to reduce the incidence of osteoporosis and fracture. Lumbar lateral position for BMD detection is the sensitive position for the early diagnosis of type Ⅰ osteoporosis.