2型糖尿病患者骨质疏松症的影响因素分析及超声诊断的应用价值

发布时间：2018-02-02 03:06

本文关键词： 2型糖尿病骨质疏松症骨密度　出处：《石河子大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:1.了解2型糖尿病患者骨质疏松症的发生情况并分析可能的影响因素。2.探讨跟骨定量超声法在骨质疏松症诊断中的临床应用价值。方法:收集2013年12月到2014年5月在石河子大学医学院第一附属医院内分泌科住院的2型糖尿病患者的一般资料、生化指标及并发症发生情况,以双能X线骨密度仪检测结果为诊断金标准,将2型糖尿病患者分为骨质疏松症组、非骨质疏松症组,运用卡方检验进行危险因素单变量分析,二分类变量的Logistic回归进行多变量分析,观察2型糖尿病患者骨质疏松症的发生情况并分析可能的影响因素,同时应用定量超声骨密度检测仪检测患者跟骨的骨强度,绘制受试者工作特征曲线,探讨跟骨定量超声法在骨质疏松症诊断中的临床应用价值。结果:单变量相关分析显示:病程(OR=2.684)、周围神经病变(OR=4.440)、高血压(OR=2.281)、冠心病(OR=2.622)与2型糖尿病性骨质疏松呈显著的正相关(P0.05),体重指数(OR=0.279)、高密度脂蛋白(OR=0.320)与2型糖尿病性骨质疏松呈显著负相关(P0.05);多变量相关分析显示BMI(OR=0.311)与2型糖尿病性骨质疏松呈显著的负相关(P0.05),周围神经病变(OR=3.795)与骨质疏松呈显著正相关(P0.05);跟骨定量超声检测法与双能X线检测法诊断男性、女性T2DM患者骨质疏松症的灵敏度分别为44.44%、34.99%,特异度分别为97.22%、99.17%,定量超声检测当T=-1.950时,受试者工作特征曲线下面积(0.807)最大时,灵敏度为57.7%,特异度为89.3%。结论:1.2型糖尿病性骨质疏松症与多种因素有关,其中病程、周围神经病变、高血压、冠心病是其危险因素,体重指数、高密度脂蛋白是其保护因素。2.定量超声检测与双能X线检测相比,在临床中有一定的诊断价值。
[Abstract]:Objective 1. To understand the occurrence of osteoporosis in type 2 diabetes mellitus and analyze the possible influencing factors. 2. To explore the clinical value of calcaneal quantitative ultrasound in the diagnosis of osteoporosis. Methods:. General data of type 2 diabetic patients hospitalized in Endocrinology Department of the first affiliated Hospital of Shihezi University Medical College from December 2013 to May 2014 were collected. According to the results of dual-energy X-ray absorptiometry, the patients with type 2 diabetes were divided into osteoporosis group and non-osteoporosis group. The single variable analysis of risk factors was carried out by chi-square test, and the multivariate analysis was carried out by Logistic regression of two classified variables. Objective: to observe the occurrence of osteoporosis in type 2 diabetes mellitus and analyze the possible influencing factors. At the same time, the bone strength of calcaneus was measured by quantitative ultrasound bone density detector, and the operating characteristic curve was drawn. Objective: to evaluate the clinical value of calcaneal quantitative ultrasound in the diagnosis of osteoporosis. Results: univariate correlation analysis showed that the course of disease was 2.684, and peripheral neuropathy was 4.440). There was a significant positive correlation between hypertension and type 2 diabetes mellitus osteoporosis (P 0.05, BMI = 0.279). High density lipoprotein (HDL) 0.320) was negatively correlated with type 2 diabetic osteoporosis (P 0.05). Multivariate correlation analysis showed that there was a significant negative correlation between BMIO 0.311) and type 2 diabetic osteoporosis (P 0.05). There was a significant positive correlation between peripheral neuropathy and osteoporosis (P 0.05). The sensitivity and specificity of calcaneal quantitative ultrasound and dual-energy X-ray in diagnosis of osteoporosis in female patients with T2DM were 44.44 ~ 34.99 and 97.22% respectively. 99. The sensitivity of quantitative ultrasound was 57.7% when the area under the operating characteristic curve was 0.807. Conclusion Osteoporosis caused by type 1.2 diabetes is related to many factors, including course of disease, peripheral neuropathy, hypertension, coronary heart disease, and body mass index. High density lipoprotein (HDL) is the protective factor. Compared with dual energy X ray detection, quantitative ultrasound has certain diagnostic value in clinic.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R580

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