跟骨超声骨密度T值-2.5以下预测脑卒中的价值分析

The value of calcaneal quantitative ultrasound（QUS） T score under-2. 5 in predicting stroke

目的：探讨跟骨定量超声（quantitative ultrasound,QUS）骨密度T值-2.5以下与脑卒中风险之间的关系。方法采用整群抽样方法,于2011年5月至10月对贵阳市云岩区5847名40岁以上成人进行详细问卷调查、体格检查、血脂等代谢相关指标及QUS跟骨骨密度的测定,并随访3年,根据随访期内是否发生脑卒中分为脑卒中组（99名）和非脑卒中组（5748名）,分析QUS跟骨骨密度T值-2.5以下与脑卒中风险之间的关系。结果脑卒中组与非脑卒中组比较,QUS跟骨骨密度T值-2.5以下者更多,差异具有统计学意义（P〈0.05）。经过调整年龄、性别和体重指数（BMI）后,发现QUS跟骨骨密度T值-2.5以下是预测脑卒中发生的独立危险因素（HR=1.467,95%CI 0.753~2.855）,继续调整吸烟、糖尿病、文化程度及高血压后,QUS 跟骨骨密度 T 值-2.5以下与脑卒中的关系仍未改变（ HR=1.265,95% CI 0.647~2.475）。结论 QUS跟骨骨密度T值-2.5以下与脑卒中风险是独立相关的,后者是预测脑卒中的独立危险因素。

Objective To explore the relationship between risk of stroke and calcaneal quantitative ultrasound（QUS）T score under-2. 5. Methods 5 847 subjects over the age of 40 from Yunyan District, Guiyang City were investigated with questionnaire, physical examination, blood lipids, other metabolic indexes and calcaneus bone density determination from May to October, 2011 by cluster sampling method and were followed up for 3 years. Subjects were divided into stroke group（99 subjects） and non-stroke group（5 748 subjects） according to the occurrence of stroke in the follow-up period. The relationship between risk of stroke and QUS T score under-2. 5 was analyzed. Results Compared to the non-stroke group, the number of subjects with T score under-2. 5 in calcaneal QUS was larger in the stroke group, the difference of which was statistically significant（P〈0. 05）. T score of bone density under-2. 5 in calcaneal QUS was found to be an independent risk factor for predicting stroke after adjusting for age, sex, and body mass index（HR=1. 467, 95%CI 0. 753-2. 855）. The relationship between risk of stroke and T score under-2. 5 in calcaneal QUS remained unchanged after further adjust ment of smoking, diabetes, education, and hypertension（HR=1. 265, 95%CI 0. 647-2. 475）. Conclusion The risk of stroke and T score of bone density under-2. 5 in calcaneal QUS was independently associated, and the latter is an independent risk factor for predicting stroke.