年龄对股骨颈骨密度和皮质厚度的影响

The effect of age on the bone mineral density and cortical thickness of the femoral neck

目的观察年龄对股骨颈骨密度和皮质厚度的影响,及与股骨颈骨折的关系。方法对73例50岁以上因髋关节疾病住院病人行股骨近段CT扫描和DXA髋部骨密度测定,分为50～65岁组、66～80岁组和>80岁组,以股骨颈骨密度为标准判断骨质疏松程度,以皮质比率作为评估皮质厚度的标准。结果股骨颈骨密度:50～65岁组为0.710±0.139、66～80岁组为0.613±0.104和>80岁组为0.572±0.061。66～80岁组和>80岁组与50～65岁组有非常显著性差异,66～80岁组与>80岁组差异无统计学意义。T20长径皮质比率:50～65岁组与66～80岁组差异无统计学意义,而66～80岁组与>80岁组有非常显著性差异。股骨颈宽径皮质比率:50～65岁组与>80岁组有非常显著性差异。结论股骨颈骨密度和皮质厚度随年龄增高而降低,提示股骨颈皮质厚度变薄是高龄髋部骨折风险高的原因之一。

Objective To observe the effect of age on the bone mineral density and cortical thickness of the femoral neck and the association with femoral neck fractures.Methods The bone mineral density of the proximal femur was measured with DXA and CT scan in 73 patients with hip diseases over 50 years old.The patients were divided into 3 groups according to age,the patients of 50-65 years old age as group 1,the patients of 66-80 years old age as group 2,and the patients over 80 years old age as group 3.Femoral neck BMD was used as the standard to evaluate the severity of osteoporosis.The cortex ratio was used as the standard to evaluate cortical thickness of the femoral neck.Results Femoral neck BMDs were 0.710±0.139 in the group 1,0.613±0.104 in the group 2,and 0.572±0.061 in the group 3,respectively.BMDs of patients in group 2 and group 3 were significantly different with those of patients in group1.However,BMDs between patients in group 2 and group 3 showed no significant difference.The results of cortex ratio of T20 long diameter showed that there was no significant difference between group 1 and group 2.However,there was significant difference between group 2 and group 3.The results of cortex ratio of wide diameter of neck at T20showed that there was significant difference between group 1 and group 3.Conclusion BMD and cortical thickness of the femoral neck decrease with age.This indicates that the thinned cortex of the femoral neck may be high risk factor for the hip fracture in the elderly patients.