运用骨小梁分数(TBS)技术评价帕金森病患者骨质量的变化

Assessment of Bone quality with Trabecular Bone Score(TBS) in Parkinson' s disease

目的研究帕金森病(PD)患者骨质量、骨量的变化。方法本研究纳入年龄≥40岁的中老年男性和女性共计276人,排除帕金森病外的其他影响骨代谢的继发性疾病及药物,分PD组和健康对照组,PD组共77人,其中男性39人,女性38人,健康对照组共199人,其中男性97人,女性102人。运用双能X线骨密度仪进行股骨颈、总髋部、腰椎BMD测定;运用骨小梁分数(TBS)技术,进行腰椎TBS的测定。分析PD组和健康对照组TBS、BMD的差异。结果 1.男性PD患者的腰椎TBS(1.261±0.074)低于男性对照组的腰椎TBS(1.298±0.073),差异有统计学意义(P=0.008);而男性PD患者的股骨颈BMD、总髋部BMD、腰椎BMD与男性对照组相比均无差异;2.女性PD患者的腰椎TBS(1.223±0.149)亦低于女性对照组的腰椎TBS(1.301±0.110),差异有统计学意义(P<0.001);同时,女性PD患者的股骨颈BMD、总髋部BMD、腰椎BMD均低于女性对照组(P值均<0.01)。结论 1.无论男性还是女性,PD患者骨质量均明显下降;2.PD患者骨量的变化则存在性别差异,男性PD患者骨量无明显变化,女性PD患者骨量则明显降低。

Objective To investigate the change of bone quality and bone mass in patients with Parkinson＇s disease（ PD）.Me thod Males and females aged 40 years and older were devided into PD group and the healthy control group,totally 276 participants. The PD group included 39 males and 38 females,the healthy control group included 97 males and 102 females.Secondary osteoporosis was excluded. Bone mineral density（ BMD） of the femoral neck,the total hip and the lumbar spine was measured using dual-energy x-ray absorptiometry. Lumbar spine trabecular bone score（ TBS） was measured by the TBS i Nsight software. The differences of TBS and BMD between PD groups and healthy control groups were analyzed. Re sults 1. The lumbar spine TBS of male PD patients（ 1. 261 ± 0. 074） was significantly lower than the lumbar spine TBS of their controls（ 1. 298 ±0. 073）,P = 0. 008. While the BMD of the femoral neck,the total hip and the lumbar spine had no difference between two groups.2. The lumbar spine TBS of female PD patients（ 1. 223 ± 0. 149） was also significantly lower than the lumbar spine TBS of their controls（ 1. 301 ± 0. 110）,P 〈0. 001. Meanwhile the BMD of the femoral neck,the total hip and the lumbar spine was all lower in female PD patients,compared with their controls. Conclusions 1. Both male and female,the bone quality of PD patients is significantly decreased. 2. The change of bone mass in PD patients varies by sex,there is no change of bone mass in male PD patients,while female PD patients have lower bone mass.