老年骨质疏松患者Agatston积分与骨密度及脆性骨折的相关性

Correlation Between Agatston Scores and Fragility Fracture in Elderly Patients with Osteoporosis

目的探讨老年骨质疏松患者Agatston钙化积分与骨密度及脆性骨折的相关性。方法回顾性分析2020年1月-2021年6月解放军联勤保障部队第900医院收治的老年骨质疏松患者183例,64排螺旋CT胸部扫描,记录Agatston钙化积分;双能X线骨密度测量仪(DEXA)测量骨密度(BMD)并记录患者骨折情况;记录临床实验室生化指标,包括碱性磷酸酶、钙、磷等。按照Agatston钙化积分将患者分为低钙化组(78例)、中钙化组(76例)和高钙化组(29例)。比较三组一般资料、实验室生化指标、BMD、脆性骨折情况,分析Agatston钙化积分与BMD及脆性骨折的相关性,评价Agatston钙化积分对脆性骨折的诊断性能。结果高钙化组年龄高于低钙化组、中钙化组(P<0.05),BMD低于低钙化组、中钙化组(P<0.05);Agatston钙化积分与BMD呈负相关(r=-0.887,P<0.05);高钙化组中脆性骨折占比最高,以髋部骨折最多;Logistic回归分析显示,Agatston钙化积分无论作为单独因素或联合因素均与脆性骨折相关;ROC曲线显示,Agatston钙化积分对脆性骨折有预测价值(AUC为0.741,P<0.05)。结论老年骨质疏松患者Agatston钙化积分与骨密度呈负相关,钙化程度越严重,发生脆性骨折的风险越高。

Objective To investigate the correlation between Agatston scores and bone mineral density and fragility fracture in elderly patients with osteoporosis.Methods A retrospective analysis of 183 elderly patients with osteoporosis admitted to the 900 th Hospital of PLA Joint Logistics Support Force from January 2020 to June 2021 was conducted.64-slice spiral CT was used for chest scanning,and Agatston scores were recorded.Bone mineral density(BMD)was measured by dual-energy X-ray absorptiometry(DEXA)and the fracture was recorded.Clinical laboratory biochemical indexes,including alkaline phosphatase,calcium,and phosphorus,were recorded.According to Agatston scores,the patients were divided into low calcification group(n=78),medium calcification group(n=76)and high calcification group(n=29).The general data,laboratory biochemical indexes,BMD and fragility fractures of the three groups were compared.The correlation between Agatston calcification score and BMD and fragility fractures was analyzed,and the diagnostic performance of Agatston calcification score for fragility fractures was evaluated.Results The age of high calcification group was higher than that of low calcification group and medium calcification group(P<0.05),and BMD was lower than that of low calcification group and medium calcification group(P<0.05).Agatston calcification score was negatively correlated with BMD(r=-0.887,P<0.05).The proportion of brittle fractures in the high calcification group was the highest,with the most hip fractures.Logistic regression analysis showed that Agatston calcification score was associated with fragility fracture whether as a single factor or combined factor.ROC curve showed that Agatston calcification score had predictive value for fragile fracture(AUC=0.741,P<0.05).Conclusion Agatston score is negatively correlated with bone mineral density in elderly patients with osteoporosis,and the more severe the calcification degree,the higher the risk of fragility fracture.