膝骨性关节炎患者膝关节局部骨密度的差异性研究

发布时间：2018-07-16 14:41

【摘要】：目的探讨膝骨关节炎患者膝关节不同分区骨密度差异性及其与骨质疏松情况的相关性。方法选取2016年3月至7月广东省中医院原发性膝骨性关节炎患者44例,共44膝(左膝22例,右膝22例);全部为绝经女性患者;年龄54~88岁,平均68.6±7.50岁。将膝关节感兴趣区(ROI)分别在正侧位上划分,正位分为6个感兴趣区,分别记为ROI 1-6区;侧位分为7个感兴趣,分别记为ROI 1-7区。利用双能X射线骨密度仪分别测量各个感兴趣区的骨密度,同时测量腰椎及股骨颈骨密度情况。根据测量结果,将不同分区BMD测量值分别进行两两间比较,采用SPSS 16.0的统计软件进行数据处理与分析。结果共纳入原发性膝骨性关节炎患者44例,腰椎BMD为0.859±0.156 g/cm2(0.592~1.168 g/cm2);股骨颈BMD为0.660±0.112 g/cm2(0.436~0.087 g/cm2)。其中骨质疏松(T值-2.5)15例,占34.1%;低骨量(-1.0T值2.5)23例,占52.3%;正常(T值-1.0)6例,占13.6%。膝关节正位感兴趣区ROI 1-6区BMD分别为:0.764±0.176、0.649±0.177、0.871±0.253、0.984±0.297、0.696±0.143、0.949±0.210。膝关节侧位感兴趣区ROI 1-7区BMD分别为:0.801±0.226、0.995±0.272、0.964±0.298、0.942±0.198、0.796±0.157、0.870±0.223、0.752±0.206。膝关节正位感兴趣区骨密度情况对比发现,ROI 1、ROI 2、ROI 3、ROI 4,四个分区相互间BMD测量值比较有统计学差异(P0.05);其中BMD测量值ROI 4ROI 3ROI 1ROI 2。膝关节侧位感兴趣区骨密度情况对比发现,ROI 1与ROI 2、ROI 3、ROI 4的BMD测量值比较有统计学差异(P0.05);ROI 1 BMD测量值最小。ROI 4、ROI 6分别与ROI 5、ROI 7的BMD测量值比较有统计学差异(P0.05);ROI 4、ROI 6的BMD测量值大于ROI 5、ROI 7的BMD测量值。结论膝骨关节炎患者大部分合并骨质疏松,膝骨关节炎与骨质疏松,相互影响,相互联系,导致疾病的不断发展。膝关节不同分区骨质量退变情况不同,胫骨平台内侧BMD测量值比胫骨平台外侧高,股骨外侧髁BMD测量值比股骨内侧髁;同时股骨髁、股骨干较胫骨平台、胫骨干、髌骨BMD测量值高。
[Abstract]:Objective to investigate the difference of bone mineral density (BMD) in different zones of knee joint in patients with knee osteoarthritis and its correlation with osteoporosis. Methods from March to July 2016, 44 patients with primary knee osteoarthritis (22 patients with left knee and 22 patients with right knee) were selected from Guangdong Provincial Hospital of Chinese Medicine, all of whom were menopausal women, aged 548.88 years (mean 68.6 卤7.50 years). The region of interest (ROI) of knee joint was divided into 6 regions of interest (ROI 1-6) and 7 regions of interest (ROI 1-7) respectively. Dual energy X ray absorptiometry was used to measure the bone mineral density of each region of interest, and the bone mineral density of lumbar vertebrae and femoral neck. According to the measurement results, the BMD measurements in different zones were compared and the data were processed and analyzed by SPSS 16.0 software. Results 44 patients with primary knee osteoarthritis were included. The BMD of lumbar vertebrae was 0.859 卤0.156 g/cm2 (0.592卤 1.168 g/cm2), and that of femoral neck was 0.660 卤0.112 g/cm2 (0.436 卤0.087 g/cm2). Among them, 15 cases were osteoporosis (T value -2.5), 23 cases were low bone mass (-1.0 T value 2.5), and 6 cases were normal (T value -1.0), accounting for 13.6%. The BMD of ROI 1-6 in the ROI 1-6 area of the orthotopic position of the knee joint was: 0. 764 卤0. 176 卤0. 649 卤0. 177 卤0. 871 卤0. 253 卤0. 984 卤0. 297V 0. 696 卤0. 143 ~ 0. 949 卤0. 210 respectively. The BMD of ROI 1-7 area in lateral position of knee joint was: 0. 801 卤0. 226 卤0. 995 卤0. 272 卤0. 964 卤0. 298 9. 942 卤0. 198 0. 796 卤0. 157 0. 870 卤0. 22323. 752 卤0. 206 respectively. The bone mineral density of the area of interest in orthotopic position of knee joint was compared with that of ROI 1, ROI 2 ROI 3 ROI 3 ROI 4, and the BMD values of ROI 4 ROI 3 ROI 1 ROI 2 were significantly different among the four subdivisions (P 0.05), and the BMD values of ROI 4 ROI 3 ROI 1 ROI 2. Comparison of BMD between ROI 1 and ROI 2 ROI 3 ROI 4 in lateral area of interest of knee joint there was significant difference between BMD measurement values of roi 1 and ROI 2 ROI 3 roi 4 (P 0.05) the minimum BMD value of roi 1 BMD. ROI 4 ROI 6 was significantly different from that of ROI 5 ROI 7 (P 0.05). The BMD value of 6 is larger than that of ROI 5 / ROI 7. Conclusion most of the patients with knee osteoarthritis are complicated with osteoporosis, and the relationship between osteoarthritis and osteoporosis leads to the development of the disease. The BMD of the medial tibial plateau was higher than that of the lateral tibial plateau, and the BMD of the lateral femoral condyle was higher than that of the medial femoral condyle, and the femoral condyle and the femoral shaft were higher than those of the tibial plateau and the tibial trunk. The BMD of patella was high.
【作者单位】：广东省中医院;
【基金】：广东省中医药局科研项目(20172081)
【分类号】：R684.3

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