髋部肌肉密度下降对老年股骨近端骨折的影响

Effect of decline of hip muscle density on proximal femoral fracture in the elderly

目的探讨髋部肌肉密度变化对老年股骨近端骨折的影响。方法选择行髋部CT检查的股骨近端骨折患者（骨折组）41例及健康者（对照组）14例作为研究对象。骨折组男14例，女27例；年龄（64．1±5．1）岁。股骨颈骨折19例，股骨转子间骨折22例。对照组男4例，女10例；年龄（64．8±3．9）岁。收集两组患者的CT影像资料，分析年龄与髋部前群、内侧群、后群髋部肌肉密度的相关性；比较骨折组患者健侧与患侧髋部前群、内侧群、后群肌肉密度；比较骨折组与对照组髋部前群、内侧群、后群肌肉密度，分析其对老年股骨近端骨折的相关性。结果年龄与髋部前群、内侧群、后群髋部肌肉密度均呈负相关；骨折组患者健侧与患侧髋部前群、内侧群、后群肌肉密度比较差异无统计学意义；在排除年龄、性别等影响因素后，骨折组髋部前群、后群肌肉密度分别为[（34．8±4．1）Hu、（22．1±5．5）Hu]，对照组分别为[（44．4±5．7）Hu、（39．2±5．3）Hu]，骨折组明显低于对照组（P〈0．05），两组髋部内侧群肌肉密度差异无统计学意义。结论随着年龄增长髋部肌肉密度降低，股骨近端骨折对患侧髋部肌肉密度无明显影响。髋部肌肉密度下降可能增加老年股骨近端骨折的风险。

Objective To definite the correlation of hip muscle density with proximal femoral fracture in the elderly. Methods The study included 41 proximal femoral fracture cases [ 14 males and 27 females, at age of （64. 1 ±5.1）years] and 14 normal cases [4 males and 10 females, at age of （64. 8 ± 3.9） years] that underwent CT examination for hip joint. In fracture group, 19 cases sustained femoral neck fracture and 22 intertrochanteric fracture. CT imaging data were reviewed to analyze the correlation of age with hip muscle density at the level of ischium tubercle. Hip muscle density was compared between fracture side and healthy side in fracture group and between control group and fracture group. Results Hip muscle density showed a downward trend with increased age （P 〈0. 05）. Hip muscle density did not differ significantly between fracture side and healthy side in fracture group （ P 〉 0.05 ）. Regardless of age, gender and other factors, hip anterior muscle density [ （34.8± 4. 1 ） Hu ] and posterior muscle density [ （22.1±5.5）Hu] were lower in fracture group than in control group [ （44.4 ±5.7）Hu, （39.2 ±5.3）Hu respectively, P 〈 0.05 ] but there was no significant difference in hip medial muscle density between the two groups （P 〉 0.05）. Conclusions Hip muscle density decreases with age and has no strong correlation with fracture. Deadline of the hip muscle density may be a risk factor to proximal femoral fracture in the elderly.