跟骨定量超声筛查老年女性膝骨性关节炎患者骨质疏松的相关性研究

Role of calcaneus quantitative ultrasound in screening osteoporosis in elderly female patients with knee osteoarthritis

目的分析老年女性膝骨关节炎患者跟骨定量超声与双能X线吸收(DXA)骨密度测定结果之间的相关性。方法以101例老年女性膝骨关节炎患者为研究对象,根据年龄分为3组:﹤65岁38例,65~75岁48例,>75岁15例。均行跟骨定量超声与DXA骨密度检查,分析两者相关性;并以DXA T值评估结果为标准,分析跟骨定量超声相关指标BUA、SOS、T-score和SI对骨质疏松和骨密度降低的诊断效能。结果 >75岁患者的DXA平均T值明显低于﹤65岁患者和65~75岁患者,组间差异有统计学意义(P<0.05);65~75岁患者的BUA、T-score、SI明显低于﹤65岁患者,>75岁患者的BUA、T-score、SI明显低于65~75岁患者,组间差异有统计学意义(P<0.05)。BUA值、T-score、SI与DXA T值具有良好的正相关性(R2=0.3154、0.3207,P<0.05),三者对骨质疏松和骨密度下降均有良好的诊断效能。BUA值、T-score、SI诊断骨质疏松的最佳工作点分别为:BUA=55.205 d B/MHZ,T-score=-2.47,SI=65.635;诊断骨密度降低的最佳工作点分别为:BUA=60.725 d B/MHZ,Tscore=-1.605,SI=79.196。结论跟骨定量超声结果 BUA和T-score与老年女性膝骨关节炎患者骨密度密切相关,对骨质疏松具有预测作用,有望成为其临床筛查工具。

Objective To analyze the correlation of calcaneus quantitative ultrasound with dual-emission X-ray absorptiometry( DXA) in detecting bone mineral density( BMD) of elderly female patients with knee osteoarthritis. Methods One hundred and one elderly female patients with knee osteoarthritis were divided into 3 groups according to the age : <65,n = 38; 65-75,n = 48; > 75,n = 15. The calcaneus quantitative ultrasound and DXA were performed in all the patients to detect BMD,the correlation between the results of calcaneus quantitative ultrasound and DXA was analyzed. Furthermore,with DXA T value as the standard,the diagnostic efficiency for osteoporosis and bone mineral density decreased of BUA,SOS,T-score and SI was analyzed. Results The DXA T of patients > 75 was higher than that of patients < 65 or65-75,and the difference between groups had statistical significance( P < 0. 05). The BUA,T-score and SI of patients65-75 were both lower than those of patients < 65,and those of patients > 75 were both lower than those of patients65-75,and the difference between groups had statistical significance( P < 0. 05). BUA,T-score and SI were both had positive correlation with DXA T( R2= 0. 3154,0. 3207,P < 0. 05),and both of them had good diagnostic performance for osteoporosis and BMD decrease. The best working point for osteoporosis was: BUA = 55. 205 d B/MHZ; T-score =-2. 47;SI = 65. 635. The best working point for BMD decrease was: BUA = 60. 725 d B/MHZ; T-score =-1. 605; SI = 79. 196.Conclusion BUA,T-score and SI by calcaneus quantitative ultrasound are closely related to BMD of women patients with knee osteoarthritis,which has prediction effect for osteoporosis,and is expected to become a clinical screening tool.