股骨远端皮质厚度预测老年男性骨量变化的效果评价

Performance of Distal Femoral Cortical Bone Thickness Predicting Bone Mineral Changes in Elderly Men

目的探讨股骨远端皮质厚度与骨量变化的关系,评价股骨远端皮质厚度预测骨质疏松症和骨量变化的能力。方法选取沈阳医学院附属中心医院接受膝关节前后位摄影与双能X线吸收检测法(DXA)检查的男性骨折患者87例。在膝关节正位片上测量股骨远端皮质厚度。骨量变化利用DXA测定,根据T评分分为骨质疏松、骨量减少、骨质正常。结果本研究评估了87例患者,不同组患者(骨质疏松、骨量减少、骨质正常)骨皮质厚度之间差异有统计学意义(F=17.77,P<0.001);股骨远端皮质厚度与其T评分正相关(r=0.510,P<0.0001)。股骨远端皮质厚度预测骨质疏松的ROC曲线下面积为0.803(0.679~0.903),灵敏度为78.6%,特异度为81.3%;预测骨质改变的ROC曲线下面积为0.821(0.736〜0.906),灵敏度和特异度分别为86.0%和80.0%。结论测量股骨远端皮质厚度是一种快速可靠的评估骨质量的方法,可作为骨量减少和骨质疏松的有效筛查工具。

Objective To investigate the correlation between the thickness of the distal femoral cortical and bone mineral Changes,and to evaluate the performance of the thickness of the distal femoral cortical to predict osteoporosis.Methods A total of 87 cases of male patients in our hospital who received knee joint anteroposterior photography and dual energy X-ray absorptiometry(DXA)examination were selected.The cortical thickness of distal femur was measured on anteroposterior radiographs.Bone mineral density was measured by DXA.According to T-score,the patients were divided into osteoporosis group,osteopenia group and normal group.Results In this study,we evaluated 87 patients.There was a significant difference in cortical thickness among the different groups(osteoporosis,osteopenia,and normal)(F=17.77,P<0.001).Distal femoral cortical thickness was positively correlated with T-score(r=0.51,P<0.0001).The area under the ROC curve of the thickness of the distal femoral cortical in osteoporosis was 0.803(0.679-0.903),with a sensitivity of 78.6%and a specificity of 81.3%.The area under ROC curve in bone mineral change was 0.821(0.736-0.906),with a sensitivity of 86.0%and a specificity of 80.0%,respectively.Conclusion The measurement of the distal femoral cortical is a rapid and reliable method to assess bone quality and may be an effective screening tool for osteoporosis.