女性骨质疏松性骨折骨密度阈值及中国人群骨质疏松诊断标准探讨

Exploration of the bone mineral density threshold for bone fractures in females and the osteoporosis diagnosis standard for Chinese

目的研究河南地区女性骨质疏松性骨折骨密度阈值并进一步探讨中国人群骨质疏松诊断标准。方法收集465例女性骨质疏松性骨折患者的病历资料,对双能X线测定的骨密度值、T值、Z值进行统计分析。结果女性患者腰椎BMD值低于0.7955 g/cm2、T值低于-2.15、Z值低于-0.52时,骨折风险较高;髋部BMD值低于0.7270 g/cm2、T值低于-2.10、Z值低于-1.01时,骨折风险较高。结论对于骨密度低于上述阈值者,需高度警惕骨质疏松性骨折的发生,应采取积极有效的预防和治疗措施。WHO的骨质疏松诊断标准与中国人群的骨密度情况存在一定差异,因此,应展开全国范围的骨质疏松流行病学调查工作,健全中国人群骨密度数据库,为制定适合中国人群骨质疏松诊断标准提供流行病学依据。

Objective To study the bone mineral density （BMD） threshold for osteoporotic fractures in females in Henan area, and to further explore the osteoporotic diagnosis standard in Chinese. Methods Medical records of 465 female patients with osteoporotic fractures were collected. Data of BMD, T-score, and Z-score determined using dual-energy X-ray were analyzed. Results The fracture risk was high in female patients when BMD of the lumbar vertebrae was lower than 0. 7955g/cm2 , and T-score was lower than -2.15, and Z-score was lower than -0. 52. The fracture risk was high when BMD of the hip was lower than 0. 7270g/cm2 , and T-score was lower than - 2. 10, and Z-score was lower than - 1.01. Conclusion It should be alerted of osteoporotic fractures for those whose BMD were below the above threshold. Effective prevention and treatment methods should be applied. There were differences between WHO osteoporosis diagnosis standard and the BMD situation in Chinese population. Therefore it is necessary to launch a nationwide osteoporosis epidemiological investigation, and to fulfill the BMD database of Chinese population, and to provide evidence for the establishment of Chinese osteoporotic diagnosis standard.