老年人胫骨超声检测的临床意义

Clinical significance of ultrasonic measurement of the tibia in the elderly

目的了解老年人胫骨骨强度的变化。方法用骨定量超声仪（ＱＵＳ）测量１５５例老年人和３８５例青年人胫骨超声速度（ＳＯＳ），女性同时用双能Ｘ线骨密度仪（ＤＥＸＡ）测左前臂中、远端１／３交界处骨矿密度（ＢＭＤ）。结果两组（６０～６９岁组和≥７０岁组）老年人ＳＯＳ，女性分别为３７６８±１２１和３７４８±１３２ｍｓ－１，男性分别为３９０６±１２３和３９２５±６６ｍｓ－１。老年人ＳＯＳ显著低于青年人（Ｐ＜０．００１），女性分别低５．２％±３．０％和５．７％±３．３％，男性分别低１．８％±３．１％和１．３％±１．７％，男女差异有显著性（Ｐ＜０．００１）。两组老年人骨质疏松症（ＯＰ）检出率女性分别为４６．５％和６１．１％，男性分别为１１．４％和９．１％，女性显著高于男性（Ｐ＜０．００１）。ＱＵＳ与ＤＥＸＡ的相关系数（ｒ）为０．６５７（Ｐ＜０．００１），ＯＰ检出率分别为４９．４％和５５．１％，诊断符合率为６０．０％。结论老年人胫骨ＳＯＳ明显下降，老年女性ＳＯＳ明显低于老年男性。

Objective To observe the change of tibial speed of sound (SOS) in elderly. Methods Tibial SOS was measured with bone quantitative ultrasound (QUS) apparatus in 155 elderly and 385 young adults. Bone mineral density (BMD) was simultaneously determined at distal third of left forearm by dual energy Xray absorptiometry (DEXA) in the women described above. Results The SOS in two elderly groups (6069 years and ≥70 years) were 3 768±121 and 3 748±132 m·s-1 in women and 3 906±123 and 3 925±66m·s-1 in men, respectively. The SOS was significantly decreased (P<0001) in the elderly than in the young adult. The SOS decreased 52%±30% and 57%±33% in women and 18%±31% and 13%±17% in men, respectively. There was a significantly decrease (P<0001) in women than in men. The rates of osteoporosis (OP) detected in the two elderly groups were 465% and 611% in women and 114% and 91% in men with also, a significant decrease (P<0001) in women than in men. Tibial SOS was significantly correlated with BMD at distal 1/3 site of the forearm (r=0657,P<0001). The rate of OP detected were 494% by QUS or 551% by DEXA. The coincidence in the diagnosis of OP between QUS and DEXA was 600%. Conclusions SOS decreased at the tibia in the elderly people. The tibial SOS was significantly lower (P<0001) in elderly women than in elderly men.