定量超声检测对绝经后骨质疏松症的应用价值

The diagnostic value of quantitative ultrasound detection in postmenopausal osteoporosis

目的评价定量超声检测技术(QUS)对绝经后骨质疏松症的临床应用价值。方法 88例绝经后女性分别使用QUS测量左跟骨T值、双能X线吸收法(DXA)测量L1-4及髋部骨密度、T值,采用Spearman分析两种检测方法相关性。以DXA法诊断骨质疏松症(OP)为金标准,分析QUS诊断OP的ROC曲线下面积、cutoff、灵敏度、特异度、符合率、Youden指数。结果相关分析显示,QUS测量左跟骨与DXA测量L1、L2、L3、股骨颈、大转子、全髋T值相关系数分别为0.244、0.252、0.371、0.485、0.539、0.506(P<0.05或P<0.01);ROC曲线下面积0.669,以QUS测量T值-2.35为cutoff,QUS诊断OP的灵敏度、特异度、符合率、Youden指数分别为69.1%、65.0%、64.77%、0.341。结论 QUS与DXA检测骨密度存在相关性,可作为OP的筛查工具,但诊断效能一般,不可替代DXA检查。

Objective To evaluate the clinical value of quantitative ultrasound （QUS） detection in postmenopausal osteoporoSis （OP）. Methods A total of 88 postmenopausal women were selected. The T value of the left calcaneus was measured using QUS, while the bone mineral density （BMD） of the L,.4 vertebrae and the hip was measured using dual-energy X-ray absorptiometry （DXA）. The method of Spearman analysis was adopted to analyze the correlation between QUS and DXA. The gold standard for the diagnosis of OP was the measurement of BMD using DXA. The area under the ROC curve, cutoff, sensitivity, specificity, consistent rate, and Youden index were analyzed when QUS was used to diagnose OP in this study. Results According to the correlation analysis, the correlation coefficients between T value of the left calcaneus, detected using QUS, and T value of L1, L2, L3, the femoral neck, the trochanter, and the total hip, detected using DXA, were 0.244, 0.252, 0. 371, 0. 485, 0. 539, and 0. 506, respectively （P 〈 0. 05 or P 〈 0. 01 ）. The area under the ROC curve was 0. 669. With a T score cutoff of -2. 35 detected using QUS, the sensitivity, specificity, coincidence, and Youden index were 69.1% , 65.0% , 64. 77% , and 0. 341, respectively. Conclusion QUS has the correlation with DXA in the detection of BMD, which can be used for the screening of OP. But QUS can not replace DXA with a weak diagnostic efficacy.