绝经后妇女定量CT法骨密度测量值与骨质疏松性脊柱脆性骨折相关性研究

A study on correlation between bone mineral density measured by quantitative CT and fragile fracture of osteoporotic spine in postmenopausal women

目的探讨定量CT法(QCT)骨密度(BMD)测量值与骨质疏松性脊柱脆性骨折相关性,寻找引起脆性骨折的BMD值的临界值范围。方法对2016年6月至2018年3月住院的、第一次出现单个脊柱脆性骨折的80例绝经后妇女,应用64排CT测量患者T11~L4中未骨折椎体的QCT骨密度值进行分析;与同期80例自愿参与的符合纳入标准的无症状绝经后妇女T11~L4椎体的QCT骨密度值进行对比分析。结果试验组QCT骨密度值在35~50mg/cm^3区间的有63人,占78.75%;QCT骨密度值在50mg/cm^3以下的有69人,占86.25%,在50mg/cm^3以上的仅有11人,占13.75%;平均值为(43.63±7.54)mg/cm^3。对照组QCT骨密度值在50~70mg/cm^3区间的有53人,占66.25%;QCT骨密度值在50mg/cm^3以上的有73人,占91.25%,在50mg/cm^3以下的只有7人,占8.75%;平均值为(64.57±12.07)mg/cm^3。试验组与对照组的QCT骨密度平均值比较差异有统计学意义(t=13.158,P<0.001)。结论绝经后有骨质疏松的妇女,当其QCT骨密度值降低到50mg/cm^3左右时极易出现骨质疏松性脆性骨折,QCT骨密度值50mg/cm^3很可能是引起脆性骨折的骨密度的临界值。

ObjectiveTo evaluate the correlation between the measured value of bone mineral density(BMD) measured by quantitative CT(QCT) and fragile fracture of osteoporotic spine,so as to find the critical value scope of BMD for fragile fracture. Methods80 postmenopausal women who hospitalized from June 2016 to March 2018 with single fragile fracture of the spine for the first time were enrolled in this study.The values of BMD of QCT of non-fractured vertebrae in T 11 ~L 4 was measured by 64-slice CT and compared with those of 80 asymptomatic postmenopausal women who volunteered to participate and met the inclusion criteria in the same period. ResultsIn the experimental group,63 cases(78.75%) had QCT bone mineral density in the range of 35~50 mg/cm^3,69 cases(86.25%) had QCT bone mineral density below 50 mg/cm^3,and only 11 cases(13.75%) had QCT bone mineral density above 50 mg/cm^3.The average value was(43.63±7.54)mg/cm^3.In the control group,53 cases(66.25%) had QCT bone mineral density in the range of 50~70mg/cm^3,73 cases(91.25%) had QCT bone mineral density above 50 mg/cm^3,and only 7 cases(8.75%) had QCT bone mineral density below 50 mg/cm^3.The average value was(64.57±12.07)mg/cm^3.The difference of the average value of QCT bone mineral density between the experimental group and the control group was statistically significant( t =13.158, P <0.001). ConclusionPostmenopausal women with osteoporosis are prone to osteoporotic fragile fracture when their QCT bone mineral densities reduce to about 50 mg/cm^3,and the QCT value of 50 mg/cm^3 is likely to be the critical value of BMD for fragile fracture.