探讨用胫骨骨超声诊断骨质疏松症的标准和预测绝经妇女骨折的阈值

Diagnostic criterion of osteoporosis and fracture threshold for postmenopausal women based on quantitative ultrasound

目的 探讨用胫骨骨超声诊断骨质疏松症的标准及绝经妇女骨折的阈值。方法 对北京城区 40岁以上健康女性 3 99名和 70例有骨折史的绝经妇女进行胫骨骨超声速率的测定。 结果胫骨骨超声速率随着年龄的增加而下降 ;用 2 0～ 40岁健康年轻人胫骨骨超声速率的平均值分别减去2 0SD和 2 5SD ,165名 45岁以上的健康人中低于 2 0SD的占 16 7% ,骨折患者中占 80 0 % ;低于2 5SD的占 12 7% ,骨折患者中占 67 1%。结论 用本地女性胫骨骨超声速率的峰值减去 2 0SD作为骨质疏松症的诊断标准较适合 ;用 2 0～ 40岁年轻女性胫骨骨超声速率均值减去 2 0SD 。

Objective To study the clinical application of quantitative ultrasound to diagnostic criterion of osteoporosis and fracture threshold for post menopause women.Methods 399 healthy women aged over 40 years and 70 postmenopausal women with history of fracture in Beijing area included in this study.Speed of sound (SOS) was mearsured in the middle of tibia by ultrasound scan (Sound Scan 2000,Myriad,lsreal).Results The rate of bone loss was increased for females after 50 years of age.Taking the mean SOS in young females aged 20 40 years minus 2.0SD and 2 5SD as cut off values, the mean minus 2.0SD was found in SOS of 56 in 70 fractured females 16 7% of 165 healthy women and in 80.0% of fractured postmenopausal women,while the mean SOS minas 2 5SD was found in 12 7% of healthy women and in 67 1% of fractured postmenopausal women. Conclusion The peak bone mass value of mean SOS of tibia minus 2.0 SD may be used as diagnostic criterion of osteoporosis. The mean SOS in tibia of young females aged 20 40 years minus 2 SD can be taken as the fracture threshold risk for postmemopausal women in Beijing area.