128层CT定量参数与女性绝经后骨质疏松性髋部骨折类型的关系分析

Relationship be ween 128-slice CT Quantitative Parameters and Types of Postmenopausal Osteoporotic Hip Fracture in Women

目的分析128层计算机断层扫描(CT)定量参数与女性绝经后骨质疏松性髋部骨折类型的关系。方法选取2021年12月至2022年12月在本院就诊的126例绝经后骨质疏松性髋部骨折女性患者,根据其骨折类型将其分为股骨颈组(72例)和转子间组(54例)。比较两组患者的一般资料,骨代谢指标[血清Ι型胶原交联C末端肽(CTX)、Ι型胶原N-端前肽(PΙNP)和25羟基维生素D(25-OH-D)],128层CT定量参数[骨密度(BMD)、股骨颈区最小横截面积(CSA)、横截面转动惯量(CSMI)、屈曲应力(BR)和皮质骨厚度(CTh)];采用ROC曲线分析上述指标和参数对患者骨折类型的诊断价值。结果股骨颈组和转子间组患者一般资料、骨代谢指标,股骨颈区、大转子区、Ward三角区、转子间区和全髋的骨密度、股骨颈区的CTh、股骨颈区和转子间区的CSA、CSMI和BR比较,差异无统计学意义(P>0.05);股骨颈组患者转子间区的CTh大于转子间组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,转子间区的CTh(AUC=0.747)值对绝经后骨质疏松性髋部骨折女性患者骨折类型具有诊断价值(P<0.05)。结论128层CT定量参数中的转子间区的CTh值对绝经后骨质疏松性髋部骨折女性患者骨折类型具有一定诊断价值。

Objective To analyze the relationship between quantitative parameters of 128-slice computed tomography(CT)and the types of postmenopausal osteoporotic hip fracture in women.Methods A total of 126 postmenopausal female patients with osteoporotic hip fractures treated in the hospital were enrolled between December 2021 and December 2022.According to fracture types,they were divided into femoral neck fracture group(72 cases)and intertrochanteric fracture group(54 cases).The general data,bone metabolism indexes[serum C-terminal crosslinking telopeptide of type I collagen(CTX),procollagen type I N propeptide(PINP),25-hydroxyvitamin D(25-OH-D)]and 128-slice CT quantitative parameters[bone mineral density(BMD),minimum cross-sectional area(CSA),crosssectional moment of inertia(CSMI),buckling stress ratio(BR),cortical bone thickness(CTh)]in the two groups were compared.The diagnostic value of the above indexes and parameters for fracture types was analyzed by ROC curves.Results There was no significant difference in general data,bone metabolism indexes,bone mineral density of femoral neck,greater trochanter,Ward triangle region,intertrochanter region and whole hip,CTh of femoral neck,CSA,CSMI and BR of femoral neck and intertrochanter region between the two groups(P>0.05).CTh of intertrochanter region in femoral neck fracture group was thicker than that in intertrochanteric fracture group(P<0.05).The results of ROC curves analysis showed that CTh of intertrochanter region(AUC=0.747)was of diagnostic value for fracture types in postmenopausal female patients with osteoporotic hip fractures(P<0.05).Conclusion In 128-slice CT quantitative parameters,CTh of intertrochanter region has certain diagnostic value for fracture types in postmenopausal female patients with osteoporotic hip fractures.