双光能X射线骨密度测量对不同部位骨质疏松检出率的对比研究

Comparative study of the detection rate of osteoporosis at different detection region by dual-energy X-ray absorptiometry

目的:探讨在双光能X射线骨密度测量中,腰椎和左右两侧股骨骨质疏松检出率的差异。方法:选取4000例临床科室推送的需行骨密度检查的患者,进行腰椎和两侧股骨的骨密度测量,按照病情分类将其分为A、B、C、D共4组。A组为无继发性骨质疏松症因素的患者;B组为有继发性骨质疏松症因素患者;C组为右侧有较重的下肢疼痛、关节炎、抽筋及骨质疏松性骨折病症患者;D组为左侧有较重的下肢疼痛、关节炎、抽筋及骨质疏松性骨折病症患者。对4组患者左右两侧股骨颈骨密度值、骨质疏松及低骨量检出率进行对比分析。结果:A组与B组患者的左右两侧股骨颈骨密度值相比均无差异(t=1.371,t=1.490;P>0.05);左右两侧股骨颈骨质疏松及低骨量检出率相比均无差异(x^2=1.890,x^2=1.957;P>0.05)。C组与D组患者的左右两侧股骨颈骨密度值相比有差异(t=2.494,t=2.371;P<0.05),左右两侧股骨颈骨质疏松及低骨量检出率相比均有差异(x^2=5.593,x^2=5.043;P<0.05)。结论:对于有下肢疼痛、关节炎、抽筋以及骨质疏松性骨折病症的患者,测量腰椎和双侧股骨的骨密度值并选取最低的T值作为判断标准,能够提高骨质疏松及低骨量的检出率。

Objective： To investigate the measurement difference of left and right femoral bone mineral density（BMD） in dual-energy X-ray absorptiometry（DXA）. Methods： 4000 patients＇ BMD with DXA in dual femora（femoral neck, femoral trochanter, upper femoral neck and total hip joint） results were enrolled in this study, and a statistical analysis according to different symptoms were compared. All the patients were divided into four groups, including patients with no secondary factors of osteoporosis（group A）, patients with secondary factors of osteoporosis（group B）, patients with heavier pain, arthritis, cramps, and symptoms of osteoporotic fracture on the right lower limb（group C）, and patients with heavier pain, arthritis, cramps, and symptoms of osteoporotic fracture on the left lower limb（group D）. Results： There was no significant difference about BMD values, osteoporosis and detection rate of osteopenia in group A and B on the left and right femoral（t=1.371, t=1.490; P〈0.05）,（x^2=1.890, x^2=1.957; P〈0.05）. There were significant differences about BMD values, osteoporosis and detection rate of osteopenia on the left and right femoral in group C and D（t=2.494, t=2.371; P〈0.05）,（x^2=5.593, x^2=5.043; P〈0.05）. Conclusion： Partial dual femur measurement can increase the detection rate of osteoporosis in patients with arthritis, cramps and osteoporosis with bone fracture using the lowest T value as measurement standard.