X线骨密度及股骨颈几何参数测量在不同海拔地区老年患者股骨结构评价的价值分析

Application of bone density measured by X-ray absorptiometry and femoral neck geometric parameters in the evaluation of femoral structures in elderly patients at different altitudes

目的:探究分析X线骨密度及股骨颈几何参数测量在不同海拔地区老年患者股骨结构评价的价值。方法:收集平原和高原地区老年人经双能X骨密度测量仪测得的骨密度及相应的T值,和股骨颈的相关几何参数资料,包括股骨颈轴长中点的外周直径(OD)、横截面积(CSA)、内皮质直径(ED)、平均皮质厚度(CT)、抗曲比率(BR)、截面系数(SM)、截面转动惯量(CSMI)和抗压强度指数(CSI)等。根据地区海拔不同,将老年人分为高原组和平原组,利用统计学软件分析两组患者数据之间的关系。结果:①高原组老年人骨质正常、低骨质和骨质疏松所占人数及比例分别为:120(24.0%)、263(52.6%)、117(23.4%),骨密度为(0.643±0.124)g/cm^2;平原组老年人骨质正常、低骨质和骨质疏松所占比例分别为:118(23.6%)、272(54.4%)、110(22.0%),骨密度为(0.664±0.117)g/cm^2,差异具有统计学意义(P<0.05)。②高原组老年人股骨颈几何参数与平原老年人股骨颈几何参数相比(FN表示股骨颈),其中FN-OD、FN-CSA、FN-BR和FN-SM参数数值差异不具有统计学意义(P>0.05),FN-CT、FN-ED、FN-CSMI和FN-CSI参数之间存在显著差异(P<0.05)。结论:X线骨密度及股骨颈几何参数测量对不同海拔地区老年患者股骨结构的评价具有一定价值,老年群体骨密度的大小与股骨颈的相关参数(FN-CT、FN-ED、FN-CSMI、FN-CSI)之间存在一定联系,其是评价老年患者股骨结构的重要参考,值得临床上进一步深入研究。

Objective To explore the value of bone density measured by X-ray absorptiometry and femoral neck(FN) geometric parameters in the evaluation of femoral structures in the elderly at different altitudes. Methods The bone density measured by double-energy X-ray absorptiometry and the corresponding T values of the elderly in plain and plateau areas were analyzed, and the relevant FN geometric parameters were also collected. FN geometric parameters included outer diameter(OD), cross-sectional area(CSA), endocortical diameter(ED), average cortical thickness(CT), buckling ratio(BR), section modulus(SM), crosssectional moment of inertia(CSMI) and compressive strength index(CSI) of the midpoint of FN axis. According to different altitudes, the elderly were divided into plateau group and plain group, and the relationship between physiological data of the two groups of patients was statistically analyzed. Results ① The numbers and proportions of normal bone, bone loss and osteoporosis in plateau group were 120(24.0%), 263(52.6%) and 117(23.4%), respectively, and the bone mineral density was(0.643±0.124) g/cm^2. Those in plain group were 118(23.6%), 272(54.4%) and 110(22.0%), respectively, and the bone mineral density was(0.664±0.117) g/cm^2. There were statistical differences between two groups(P<0.05). ②The comparison of FN geometric parameters between plateau group and plain group showed that there were significant differences in FN-CT, FN-ED,FN-CSMI and FN-CSI(P<0.05), but not in FN-OD, FN-CSA, FN-BR and FN-SM(P>0.05). Conclusion The bone density measured by X-ray absorptiometry and FN geometric parameters have certain value in evaluating the femoral structure in elderly patients at different altitudes. There is a certain relationship between bone density of the elderly and some FN geometric parameters(FN-CT, FN-ED, FN-CSMI and FN-CSI), which provide significant reference for the evaluation of the femoral structure in elderly patients, worthy of further clinical research.