双能X线吸收仪测定骨密度对骨质疏松症的诊断价值

Analysis of Dual-energy X-ray Absorptionmetry in Measurement of Bone Mineral Density in 2 115 Patients

目的:应用双能X线吸收仪(DEXA)测定腰椎L2～4前后位(anterior鄄post,A鄄P正位)和侧位的骨密度(BMD),以界定L2～4前后位和侧位男、女患者骨质疏松症(OP)的诊断临界值。方法:测定2115例患者L2～4的BMD,其中前后位1018例,侧位1097例。以T值≤-2.0s和≤-2.5s为诊断标准进行OP检出率分析。结果:按T值≤-2.0s、≤-2.5s计算,其中女性L2～4前后位的OP检出率分别为32.5%和14.5%,侧位分别为59.0%和33.4%;男性L2～4的前后位OP检出率分别为17.6%和6.4%,侧位分别为45.9%和17.8%。无论男女,以T值≤-2.0s为标准时,L2～4前后位与侧位的OP检出率差异显著(P<0.01)。L2～4前后位以T值≤-2.0s为标准的OP检出率和侧位以T值≤-2.5s为标准的OP检出率一致(P>0.05)。结论:男、女性L2～4前后位BMD测定可参考以T值≤-2.0s作为OP的诊断标准,侧位可参考以T值≤-2.5s作为诊断标准。

To evaluate the value of bone mineral density(BMD)measurement with dual-energy X-ray absorption-metry(DEXA)in the diagnosis of osteoporosis.Methods:The BMD(L 2-4 spine)of2115patients was measured:1018in A-P position and1097in lateral position.The detecting rate of osteoporosis was statistically analyzed according to T-score≤-2.0s and T-score≤-2.5s.Results:The detecting rate of osteoporosis in female with T-score≤-2.0s and T-score≤-2.5s were32.5%and14.5%in A-P position,59.0%and33.4%in lateral position respectively,and in male with T-score≤-2.0s and T-score≤-2.5s were17.6%and6.4%in A-P position,45.9%and17.8%in lateral position respec-tively.Regardless of sex,the difference between detecting rates of T-score≤-2.0s,A-P and T-score≤-2.5s,lateral were not significant(P>0.05).Conclusion:T-score≤-2.0s of BMD(L 2-4 )measured in A-P position and T-score≤-2.5s in leteral position could be used as a criterion of the osteoporsis diagnosis both in female and male.