临床诊断中骨密度测定的若干问题

Several issues related to the measurement of bone mineral density in clinical diagnosis

结合国内外有关骨密度测定的最新研究进展及本院的一些研究资料,重点对骨密度报告中的T值和Z值,在不同年龄层次中有不同的适用范围;T值结合Z值能更好地反映骨折风险,Z值小于-2时,应是警戒信号;骨密度测定中的正常人参考数据库问题,使用不同种族年轻人的标准参考数据库,对同一病人会产生不同的T值;Ward,s三角区不能作为诊断部位;骨密度的质控问题等临床诊断中骨密度测定的若干问题进行综述,并对这些观点的理论基础和依据展开讨论。

This article combines the national and international research progress of bone densitometry our hospital, focuses on the T-value and Z-value in the measurement of bone mineral density （BMD） and the research materials in The application range of T- value and Z-value varies according to different age groups. T-value combined with Z-value can better predict the risk of fractures, and Z-value smaller than 2 is a warning signal. The problems concerning the reference database of normal people in bone densitometry measurement and standard reference of young people from different race may result in different T-values, even for the same patient. BMD of Ward＇ s region can not be used for diagnosis. Clinical quality control of BMD is also concerned. This paper reviews these problems in the measurement of BMD in clinical diagnosis and discusses the theoretical foundation and evidence of these problems.