杭州健康女性定量骨超声测定原发性骨质疏松

Speed of sound measured in evaluation of osteoporosis in normal women in Hangzhou

目的 评价杭州健康女性骨超声速度 (SOS)值随增龄减少和骨质疏松患病率 ,建立杭州地区女性骨超声速度值参考数据库。方法 定量超声法测定 1 2 0 8例杭州地区健康女性桡骨远端(RAD) ,第 3指骨近节 (PLX) ,第V跖骨 (MTR)和胫骨中段 (TIB)的超声速度值。结果 RAD、PLX、MTR和TIBSOS峰值 (PeakofSOS)均出现在 40～ 45岁 ,TJB的SOS峰值出现在 35～ 40岁 ,此后随年龄增长而下降。绝经后妇女在绝经后早期和晚期各有 1个SOS快速减少期 ,前者见于桡骨近端 ,平均年减少率为 2 4% ,后者见于胫骨中段 ,平均年减少率为 1 8%。各部位骨SOS累积减少率随年龄增长而增加 ,到 85岁 4部位累积减少为 1 3 %～ 1 8%。 60岁以后骨质疏松性症 (OP)检出率为 45 %～ 70 % ,OP检出率以桡骨远端最高 ,60～ 70岁平均为 67% ,第 3指骨近端次之约 50 % ,胫骨中段最低为 36 % ;75岁以后分别为 70 % ,65 %和 45 %。结论 全身各部位骨超声速度值到达峰值的年龄不同 ,峰值也各有差异。绝经后妇女骨超声速度值随年龄增加减少较快 ,应予激素和补钙治疗 。

Objective To establish the parameter database of bone speed of sound in healthy women in Hangzhou and the criterion for diagnosis of osteoporosis(OP) Methods Quantitative ultrasound values of SOS using Sunlight Omnisense TM 7000S were measured in the distal 1/3 radius (RAD), the proximal phalanx of the third finger (PLX), metatarsal V (MTR) and mid shaft tibia (TIB) in 1208 cases Results The peak of SOS was found in women 35～45 years old in four sites; there after the values of SOS decreased with age There were two accelerated SOS slackening stages at early and later post menopausal periods The former was observed at RAD within 10 years post menopause with a decrease in SOS by 2 4% per year while the latter was found at TIB with a decrease by 1 8% per year 25 years after menopause The accumulative SOS slackening age increased with age The rate of accumulative SOS slackening was 13%～18% by 85 years of age OP was detected in 34～70% of women over 60 years old The detection rate of OP was highest at RAD, second at PLX and lowest at RIB Conclusion The peak SOS values differ with the age and the sites of fracture The SOS slackening is accelerated affter menopause; the physician should pay attention to this result and give proper therapy The RAD is the sensitive site of bone SOS measured and OP detected