骨密度联合椎体骨折评估在椎体脆性骨折中的应用

发布时间：2018-06-23 14:01

本文选题：椎体脆性骨折 + 骨密度　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的:探讨绝经后妇女椎体脆性骨折的危险因素及不同部位椎体脆性骨折的影响因子。方法:通过DXA(Dual-energy X-ray Absorptiometry,双能X线骨密度仪)连续检测274例50岁以上无症状绝经后妇女腰椎(L1-L4)、股骨颈和全髋骨密度同时,应用VFA(Verterbral Fracture Assessment,椎体骨折评估软件)发现椎体脆性骨折;收集所有受检者一般资料。按照WHO骨质疏松症诊断标准将受检者分为正常骨量组、低骨量组,骨质疏松组。根据椎体骨折部位分为胸椎骨折组、腰椎骨折组、胸腰椎复合骨折组。结果:274例受检者经VFA检查发现有103例椎体脆性骨折。1.单因素分析显示年龄、绝经年限、绝经年龄及各部位BMD(Bone Mineral Density,骨密度)是绝经后妇女椎体脆性骨折的可能影响因子(P0.05)。2.选择单因素分析有统计学意义并经共线性诊断的变量,进一步行多因素二分类Logistic回归分析显示:绝经年限及全髋BMD是椎体脆性骨折的危险因素(P0.05)。3.不同部位椎体脆性骨折组比较:胸腰椎复合骨折组绝经年限最长,股骨颈BMD及腰椎BMD最低;腰椎骨折组腰椎BMD较低;胸椎骨折组股骨颈BMD较低(P0.05);4.BMD联合VFA骨质疏松诊断率提高了7.3%(P0.05)。结论:绝经年限增加、全髋BMD降低对绝经后妇女椎体脆性骨折有重要的预测价值。绝经年限、股骨颈BMD及腰椎BMD与不同部位椎体脆性骨折有关。对绝经后妇女椎体脆性骨折的防治在重视骨密度的同时要联合进行椎体骨折评估,以提高椎体脆性骨折及骨质疏松诊断率。
[Abstract]:Objective: to investigate the risk factors of brittle fracture of vertebral body in postmenopausal women and the influencing factors of brittle fracture of vertebral body in different parts. Methods: lumbar vertebrae (L1-L4), femoral neck and total hip density of 274 postmenopausal women over 50 years old were detected by DXA (Dual-energy X-ray absorptiometry). VFA (Verterbral fracture Assessment Software) was used to detect brittle fracture of vertebral body. Collect general information on all subjects. According to WHO diagnostic criteria of osteoporosis, the subjects were divided into normal bone mass group, low bone mass group and osteoporosis group. According to the position of vertebral fracture, it was divided into three groups: thoracic fracture group, lumbar vertebra fracture group and thoracolumbar complex fracture group. Results 103 cases of brittle fracture of vertebral body were found by VFA. Univariate analysis showed that age, menopausal age and bone mineral density (BMD) in postmenopausal women were the possible influencing factors of brittle fracture of postmenopausal women (P0.05). Multivariate logistic regression analysis showed that menopausal age and total hip BMD were risk factors of vertebral brittle fracture (P0.05). Comparison of different vertebral body brittle fracture group: thoracolumbar complex fracture group had the longest menopausal life, femoral neck BMD and lumbar BMD was the lowest; lumbar vertebrae fracture group had lower BMD of femur neck (P0.05). 4. The diagnosis rate of BMD combined with VFA osteoporosis in thoracic vertebral fracture group was increased by 7.3% (P0.05). Conclusion: the increase of menopausal life and the decrease of total hip BMD have important predictive value for postmenopausal women with brittle vertebral fracture. Menopausal period, femoral neck BMD and lumbar BMD were associated with brittle fracture of vertebral body. In order to improve the diagnostic rate of brittle fracture and osteoporosis in postmenopausal women, the prevention and treatment of brittle fracture of vertebral body should be combined with the evaluation of bone mineral density (BMD) in order to improve the diagnosis rate of brittle fracture of vertebral body and osteoporosis.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580;R687.3

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