老年女性髋部骨折与DXA骨强度参数的相关性研究

Correlation between hip fractures and DXA bone strength parameters in elderly women

目的探讨髋部骨强度参数对老年女性髋部骨折的影响。方法对2014年10月-2017年2月至南京市中医院骨伤科就诊体检、年龄大于60岁的受试者进行双能X线测定,并收集受试者髋部骨折病史等临床资料进行回顾性分析。共纳入93名受试者,按骨折史分为髋部骨折组33人,胸腰椎骨折组32人,正常组28人,对骨密度、髋部几何参数及髋部力学参数进行统计学分析。结果股骨颈BMD(g/cm^2)、全髋BMD(g/cm2)、股骨颈皮质比率(%)、股骨颈最小宽度(mm)、d3(mm)、y(mm)等参数与老年女性髋部骨折具有显著相关性。结论本项研究基于双能X线测定法,发现部分髋部几何力学参数与老年女性髋部骨折相关,具有重要的临床指导意义,同时改变了单一的"低骨量—高骨折风险"预测模式,形成"骨密度+髋部几何力学分析"多元化模式,可有效提高老年女性髋部骨折风险的预测能力。

Objective To investigate the effect of hip bone strength parameters on hip fractures in elderly women.Methods We carried out a retrospective study comprising elderly individuals aged more than 60 years old from Oct 2014 to Feb 2017.Dual energy X-ray was performed on each participant.The information of previous hip fractures was obtained.According to the history of previous fractures,93 participants were divided into hip fracture group（33 cases）,thoracolumbar fracture group（32 cases）,and control group（28 cases）.Bone mineral density,hip geometric parameters,and hip mechanical parameters were analyzed.Results Femoral neck BMD（g/cm^2）,total hip BMD（g/cm^2）,femoral neck cortex ratio（%）,femoral neck minimum width（mm）,D3（mm）,and y（mm） were significantly correlated to hip fractures in elderly women.Conclusion Based on dual energy X-ray absorptiometry,it is found that some of the hip geometric parameters are correlated to hip fractures in elderly women and have important clinical implications.The lowbone mass for high fracture risk prediction model should be replaced by bone mineral density ＋ hip geometric mechanics model.The newmodel can effectively improve the ability of prediction of hip fracture risk in elderly women.