骨质疏松与病理性骨折的相关性研究

A-study on the association between osteoporosis and pathologic fracture

目的本研究通过定量CT进行骨密度的测定,分析随着年龄增加骨密度的变化,确定易发生骨折的骨密度标准值,即骨折阈值;并为预防骨质疏松症的发生提供理论依据。方法选择来我院就诊的深圳地区骨折患者男性60人,女性64人,通过X线平片确定为骨质疏松性骨折。用定量CT(QCT)测量椎体横断面中部的松质骨结构,通过软件处理得到L1、L2、L3总的松质骨中骨矿(CaHA)密度数值(mgcm3)。结果①骨密度值与年龄呈负相关,随着年龄增长骨密度随之降低,按P<0.05确定易发生骨折的BMD阈值,男性为109.26mgcm3,女性为100.19mgcm3;②男性和女性间椎体、髋骨骨质疏松性骨折均有显著差别(P<0.01)桡骨及其他部位骨折男性和女性间无差别(P>0.05)。结论①男性易发生骨质疏松性骨折的骨密度阈值为109.26mgcm3,女性为100.19mgcm3;②随着年龄的增大,骨密度的丢失导致骨质疏松。骨质疏松是病理性骨折的病理基础,外力作用是骨质疏松性骨折的诱因。

Objective To study the changes of bone mineral content （BMC） with the increasing age by quantitative computed tomography （QCT）, to find a standard value of bone mineral density （BMD） which likely to have frature, i.e. fracture threshold and to provide evidences to prevent elder osteoporosis （OP）. Methods Sixty male and 64 female patients who were diagnosed OP by X-ray photograph were selected. The cacellous bone structure in the middle of centrum cross-section was detected by QCT and the total Ca-HA value （ mg/cm^3 ） of L1, L2, and L3 was obtained by statistical software. Results （ 1 ） Negative correlation was found between the BMD andthe age and the threshold of fracture in male was 109.26 mg/cm3 and 100.19 mg/cm^3 in female. （2） Significant difference was shown in osteoporotic vertebral spinal fractures and osteoporotic vertebral hip fractures between different genders （ P 〈 0.01 ）, but no difference was found in radius and ulna fractures and other fractures （ P 〉 0.05 ）. Conclusions （ 1 ） The clinical application of the fracture threshold would provide evidences to prevent elder fracture. （2） The reduction of BMC would cause OP with the increased age, which was the pathological basis of pathologic fracture.