济南城区正常成人腰椎骨矿密度QCT研究

Quantitative CT study on lumbar spine mineral density of healthy adult in Jinan area

目的：应用QCT检测成人腰椎骨密度,探讨济南城区成人BMD正常参考值、骨质疏松症分级诊断指标。方法：采用日本东芝Aquilion螺旋CT机及所配骨密度软件对12个年龄段1173名（男648名,女525名）符合条件的健康志愿者进行L1和L3椎体松质骨BMD检测与分析。结果：①峰值骨密度女性位于25-29岁年龄段,BMD值198.1±23.2 mg/cm^3,男性位于30-34岁年龄段,BMD值202.6±26.9 mg/cm^3。②峰值骨量过后BMD随增龄而逐渐降低（P〈0.01）,男性40岁、女性45岁年龄段时,男女均进入骨量减少期。女性55岁、男性60岁年龄段时BMD均值进入骨质疏松期。③以BMD测定值比同性别峰值减少30%以上作为骨质疏松诊断标准,并提出骨质疏松Ⅰ-Ⅲ级诊断指标。结论：①QCT诊断骨质疏松具有较高的敏感性和准确性,仅检测L1椎体即可明确骨密度状态。②骨质疏松Ⅲ级诊断指标可为临床诊断、疗效观察、骨折危险性预测及科研提供具体客观数据。

Objective：To measure lumbar BMD in normal adults and find out the diagnostic criteria of osteoporosis. Methods： All 1173（ M 648 and F 525） normal healthy adult volunteers were divided into 12 groups according to age （5 years interval for each group）. We measured the BMD of their L1 and L3 by using TOSHIBA Aquilion CT and processed by its BMD software. Results： （1） Female＇s BMD peak value was in the 25429 year group, BMD value （198. 1±23.2） mg/cm^2 , male＇s was in the 30434 year group, BMD value （202.6±26.9） mg/cm^2 ; （2） BMD would decline gradually with increasing age （ P 〈0.01） after its peak value, and both turned into decrease period when they were about 45 and 40 years old. When female＇s were 55 and males 60 years old, their average of BMD would become to reach the criteria of osteoporosis; （3） The diagnostic criteria of osteoporosis was as follows the BMD value was 30% lower than the peak value. A three-stage diagnostic scale of osteoporosis was proposed. Conclusion： （1） As a method for diagnosing osteoporosis QCT is highly sensitive and precise; （2） The setting of the diagnostic criteria of osteoporosis has become concrete and objective criteria for clinical diagnosis, therapy observation, forecasting fracture possibility and scientific research.