老年人骨矿含量分布的研究

Anatomic Distribution of Bone Mineral Density in Elderly People with Degenerative Spondylosis

目的 判断退行性脊椎病对老年人骨矿密度 (BMD)及骨质疏松诊断的影响 ,选出较适宜的BMD测量部位。资料与方法 使用双能X线吸收测量法 (DXA)测量男 16例、女 2 0例退行性脊椎病老龄者全身、腰椎及股骨颈BMD并与腰椎X线平片作比较性研究。结果 男、女骨质疏松发病率有显著性差异 ,女性高于男性。女性腰椎BMD与全身、股骨颈BMD明显相关 (P <0 .0 1)。男性腰椎BMD仅与全身BMD相关明显 (P <0 .0 1)。女性腰椎X线片骨质疏松分度与腰椎BMD明显负相关 (r =- 0 .92 5 ,P <0 .0 1) ;而男性两者无明显相关 (r =- 0 .381,P >0 .0 5 )。结论 退行性脊椎病老年男性者诊断骨减少及骨质疏松以全身骨 。

Objective To determine the effect of degenerative spondylosis on the bone mineral density (BMD) and the diagnosis of osteoporosis in aged people, and to select proper anatomic sites suitable for BMD measurement. Materials and Methods Using dual-energy X-ray absorptiometry (DXA), BMD of total body skeleton, lumbar vertebrae 2～4 and femoral neck was measured in 16 aged males and 20 aged females with degenerative spondylosis. The results were compared with the findings on plain lumbar radiographs.Results The incidence of osteoporosis in females was significantly higher than that in males. In females, BMD of the lumbar spine was well correlated with BMD of the total skeleton and femoral neck (P<0.01). In males, BMD of the lumbar spine was only correlated with BMD of the total skeleton (P<0.01). Between the lumbar BMD and the osteoporosis degree which was determined on lumbar radiographs, significant negative correlation was seen in females (r=-0.925, P<0.01), while no obvious correlation was found in males (r=-0.381, P>0.05).Conclusion In diagnosing osteopenia and osteoporosis in aged people with degenerative spondylosis, the best site for BMD is the total skeleton for males, while the best site for BMD estimation is the total skeleton or femoral neck for females.