恶性肿瘤患者骨密度改变的研究

The study on the changes of bone mineral density in patients with malignancy

目的了解恶性肿瘤患者骨密度的改变及其主要影响因素;初步探讨骨显像与骨密度改变的关系。方法对恶性肿瘤患者77例及相对年龄段的同性别对照组48例分别进行腰椎2～4(L2～4)及股骨上端骨密度测定。均行99mTc-MDP放射性核素全身骨显像。结果77例患者L2～4、股骨颈、Wards区骨密度值均明显低于同年龄对照组。但在有、无骨转移组之间无明显差异(P>0.05);而降低的程度与有否接受化疗有关。骨显像显示L2～4异常放射性分布浓聚者中57.1%见相应部位骨密度增高。结论恶性肿瘤患者常有骨密度减低,化疗可能是重要的影响因素;骨密度测定和核素骨显像联合诊断是观察骨代谢改变的敏感性指标。

Objective To observe BMD changes in patients wi th malignancy as well as investigate the relationship between the change of BMD and whole body bone imaging.Method77patients with malignancy and 48co ntrols were investigated.The BMD of1-4lumber vertebrae,femoral neck,Ward' s triangle were measured by dual energy X-ray absorptiometry(DEXA)and 99 mTc-MDP whole body bone imaging were performed by single-photon emission computed tomography(SPECT).Results The mean BMD values of L 2-4 ,femoral neck,Ward' s triangle in 77patients were significantly lower than that of controls.The decreasing was not consistent wi th metastatic bone disease(P>0.05).There was a significant correlatio n between chemotherapy and bone mineral loss.57.1%lumbar areas of incre ased activity in bone scintigraphy showed increased BMD.Conclusion Most of the patients with malignancy have BMD reduction.Chemotherapy fo r diseases may cause bone loss.A combination of skeletal scintigraphy and BMD detectio n can provide a sensitive index of bon e metabolism.