应用DEXA和pQCT检测方法探讨40～65岁女性Colles'骨折与骨质密度的关系

Colles'fracture is associated with both low areal and volumetric bone mineral density in women aged between 40 and 60

目的 探讨由轻创伤而引起的桡骨远端骨折 (Colles'骨折 )病人的骨质密度与骨折发生的相互关系。方法 我们对 85个 4 0～ 6 5岁桡骨远端轻创伤和重创伤骨折的女性 ,分别用双能量 X射线骨密度测量仪 (DEXA) ,测量腰椎 L2 - L4 及股骨颈的面密度 (g/ cm2 ) ,用肢体定量计算机断层扫描 (p QCT)测定无受伤的非惯用侧桡骨远端及非惯用侧胫骨远端的体密度 (mg/ cm3 )。 185个同年龄但无骨折史的女性作为对照组。结果 检测结果的统计学分析表明 ,由轻创伤引致的 Colles'骨折病人 ,其骨面密度和体密度均明显地低于同年龄的对照组和重创伤引致的 Colles'骨折病人 ,其骨面密度和体密度均明显地低于同年龄的对照组和重创作引致的 Colles'骨折病人。轻创伤骨折病人的 BMD与同龄同性别者比较 (Z-score) ,BMD<2 .5SD者占 12 .5% (以脊椎 BMD为指标 )和 4 1.2 % (以桡骨为指标 )。结论 检测结果表明 4 0～ 6 5岁女性因轻创伤引致桡骨远端骨折不仅与低骨质面密度有关 ,同时与体密度相关更密切 ,是骨质疏松的先兆 ,要慎防其它骨折的产生。

Objective To study the correlation between fracture of distal radius(colles'fracture)following low energy trauma in 40～65 aged women and osteoporosis.Methods 85 female patients aged between 40 and 65 years who sustained Colles'fracture were studied.DEXA was use to measure areal bone mineral density(aBMD g/cm 2) in the lumbar spine and femoral neck and pQCT was used to mersure volumic bone mineral density(vBMD mg/cm 3)in the uninjured distal radius and distal tibia.The data were compared with age matched female control subjects with no fracture.The patients were grouped into 40～50 and 51～65 age group.The mechanism of injury was subdivided into “Low energy” fracture group which were sustained by simple slip and fall,and “High energy” fracture group which were caused by fall from height,traffic,accident or crushing injuries.Menstrual status,diet and exercise habitat were also surveyed.Results SPSS 9.0 were used for statistical calculation.Oneway ANOVA and Independent Student T Test were used to compare the BMD differences beween groups.In either age group,“Low energy”fracture group had a significantly lower BMD than controls and “High energy”fracture group.12.5% of these patients were found with spinal aBMD lower than 2.5SD(Z score)while there were 41.2% of them showed distal radius vBMD lower than 2.5SD(Z score).Conclusion The results of our study indicated that Colles'fractures in 40～65 aged women caused by low energy injury were associated with significantly reduced BMD and a high proportion of patients were osteoporotic.These patients should actively protect themselves against other future fratures.