肝硬化患者腰椎骨密度CT定量评价

Evaluation of Bone Mineral Density of the Lumbar Spine in Patients with Liver Cirrhosis with Quantitative Computed Tomography

目的:应用多层螺旋CT定量分析肝硬化患者腰椎椎体骨密度变化,并探讨腰椎骨密度变化与肝硬化病变的关系。材料和方法:按骨密度扫描标准应用16层螺旋CT对70例肝硬化患者及70例对照组病例进行腰椎L1～L4层面扫描,利用QCT-5000TM骨密度分析软件对扫描层面进行骨密度(BMD)分析,测定数据进行统计学分析比较。结果:38.6%的肝硬化患者存在骨质疏松,不同年龄组肝硬化患者腰椎骨密度水平显著低于对照组(P<0.05),按Child-Pugh分级,<50岁组中,A、B、C各级间的骨密度差异都有统计学意义(P<0.05),>50岁组中,B与C、A与C级间的骨密度差异有统计学意义,不同类型肝硬化间骨质疏松发生率的差异无统计学意义。结论:肝硬化患者存在不同程度的骨质疏松,肝硬化患者骨量减少的程度及骨质疏松发生的原因与肝病的严重程度有关,与肝硬化类型无关。

Purpose Using spiral computed tomograph to analyze variations of bone mineral density in lumbar vertebral body and explore the relationship between bone mineral density of the lumbar spine and liver cirrhosis.Materials and Methods According to the standard of mineral density scanning delete,16-slices Spiral CT scanner was used to perform in the lumbar（L1-L4）spine scanning in 70patients with liver cirrhosis and 70healthy volunteers（controls）.Image postprocessing technique（the software QCT-5000TM）was employed for statistic analysis.Results 38.6% of patients with LC were found to have osteoporosis.Bone mineral density of the lumbar spine in patients with liver cirrhosis was lower than that of group in both age groups（P〈0.05）.In the group smaller than 50,there was significant difference among A,B and C grade（Child-Pugh）.But in the group bigger than 50,Significant difference was found between groups（B and C,A and C）.There is no significant difference of osteoporosis incidence among different type of hepatopathy.Conclusions Patients with liver cirrhosis has delete in varying degrees.The level of osteopenia and osteoporosis has close relationship with the severity of the hepatopathy but not the type of LC.