腰椎定量CT与双能X线骨密度仪对骨质疏松症诊断价值的对比研究

Comparative research of lumbar QCT and DXA in diagnosis of osteoporosis

目的 :探讨腰椎定量CT(QCT)与双能X线骨密度仪(DXA)对骨质疏松症的诊断价值。方法 :对200例健康无症状中老年人行QCT与DXA检查测定骨密度,并对骨密度值及2种方法对骨量减少与骨质疏松症的检出率进行比较。同时分析不同年龄段(50~59、60~69、≥70岁)人群及不同性别人群腰椎QCT检查结果。结果:QCT对骨量减少及骨质疏松症的检出率与DXA比较,差异均有统计学意义(χ~2=17.733、14.376,均P<0.05)。QCT对60~69岁人群骨量减少与骨质疏松症检出率显著高于50~59岁人群(χ~2=7.520、6.281,均P<0.05),而与≥70岁人群差异无统计学意义(P>0.05)。QCT对女性骨量减少检出率为35.96%,骨质疏松症为21.05%,显著高于男性的19.77%、9.30%(χ~2=6.246、5.036,均P<0.05)。结论 :腰椎QCT能提供精确的骨密度值,且年龄、性别与骨质疏松的发生密切相关,有助于骨质疏松症的早期诊断。

Objective：To probe into the diagnostic value of lumbar quantitative CT（QCT） and dual-energy X-ray absorptiometry（DXA） to osteoporosis. Methods：200 cases of healthy asymptomatic middle-aged and elderly people were determined bone mineral density（BMD） by QCT and DXA. The BMD values and the detection rates of osteopenia and osteoporosis measured by DXA and QCT were compared. The examination results of lumbar QCT in different age groups（50~59 years,60~69 years old,70 years of age and above） and different gender groups were analyzed at the same time. Results：The detection rates of osteopenia and osteoporosis by QCT had significantly differences with those by DXA（χ^2=17.733,14.376,respectively,P〈 0.05）.The detection rates of osteopenia and osteoporosis in the age of 60 ~69 years old people with QCT were significantly higher than those of 50~59 years old people（χ^2=7.520,6.281,respectively,P〈 0.05）,and had no significant differences with those of people aged 70 years and above（〉P 0.05）. The detection rate of osteopenia by QCT in the female was 35.96%,while that of osteoporosis was 21.05%,which were significantly higher than those of the male by 19.77% and 9.30%（χ~2=6.246,5.036,respectively,P 0.05）. Conclusions：The lumbar QCT examination can provide accurate BMD value,and the age and gender are closely related to the occurrence of osteoporosis,thus it is helpful to the early diagnosis of osteoporosis.