双能X线吸收法在分析髋部骨折患者股骨颈结构强度中的应用

发布时间：2018-06-07 17:53

本文选题：双能X线吸收法 + 骨强度　；参考：《广东医学》2017年15期

【摘要】：目的利用双能X线吸收法(DXA)研究骨质疏松性股骨颈骨折患者和健康受试者髋关节的几何结构强度,探讨各强度参数与骨折发生危险性的关系。方法在进行了100例健康者DXA双侧股骨颈骨密度(FN BMD)、骨结构参数[截面转动惯量(CSMI)、截面面积(CSA)、截面模量(SM)、皮质骨内径(ED)、皮质骨外径(OD)、皮质骨厚度(CT)、髋轴长度(HAL)、股骨颈干角(NSA)、髋关节强度指数(SI)]配对t检验比较的基础上,对59例股骨颈骨折患者与年龄匹配的健康组DXA髋部几何结构强度参数进行比较,并作为骨折危险因素变量带入条件logistic回归方程分析,计算各参数与骨折发生的相对危险性。结果双侧髋部的DXA参数均呈高度正相关(r=0.847~0.998,P0.05),部分参数存在较小但有统计学意义的差异。骨折组女性的FN BMD、CSMI、CSA、SM、CT和SI显著低于对照组女性。骨折组男性的FN BMD、CSMI、CSA、SM和SI显著低于对照组男性。经身高、体重和FN BMD校正后,骨折组女性的CSMI、SM仍然显著低于对照组女性,骨折组男性的SM显著低于对照组男性。HAL为男、女性组入选股骨颈骨折模型的唯一因素,其OR值分别为1.385和1.269。结论髋部几何结构参数差异可以解释骨折患者股骨近端骨强度的降低,DXA测量的HAL参数对于男、女性髋部骨折风险预测具有重要的临床意义。
[Abstract]:Objective to study the geometrical structural strength of hip joint in patients with osteoporotic femoral neck fracture and healthy subjects by dual energy X-ray absorptiometry (DXA), and to explore the relationship between the strength parameters and the risk of fracture. Methods the bone structure parameters of DXA bilateral femoral neck bone density (BMD) were studied in 100 healthy subjects. The parameters of bone structure [cross section rotational inertia (CRI), cross section area (CSAA), cross section modulus (SMN), cortical bone internal diameter (EDN), cortical bone diameter (ODN), cortical bone thickness (CTT), hip axis length (HALM)], and femoral axis length (HALM), were studied in 100 healthy subjects. On the basis of paired t test, NSAA, hip strength index (SI) were compared. The geometric structural strength parameters of hip in 59 patients with femoral neck fracture were compared with those in age-matched healthy group, and the relative risk of fracture was calculated by using the conditional logistic regression equation as a variable of fracture risk factors. Results the DXA parameters of bilateral hips were positively correlated with each other (P 0.05). The CT and SI of FN BMDS CSMIA SMCT and SI in fracture group were significantly lower than those in control group. The FN BMD CSMIA SM and SI in fracture group were significantly lower than those in control group. After height, weight and FN BMD were adjusted, CSMI-SM in fracture group was still significantly lower than that in control group, and SM in fracture group was significantly lower than that in control group. Their OR values were 1.385 and 1.269, respectively. Conclusion the difference of hip geometry parameters can explain the decrease of bone strength in proximal femur and the HAL parameters measured by DXA have important clinical significance for predicting the risk of hip fracture in male and female.
【作者单位】：暨南大学附属第一医院核医学科;
【基金】：广东省医学科研基金立项项目(编号:A2015129)
【分类号】：R580;R683;R816.8

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