初次髋关节置换患者术前的髋部骨密度水平

发布时间：2018-08-19 14:01

【摘要】：目的探讨初次髋关节置换患者术前的髋部骨密度(BMD)水平。方法将150例患者分为两组。骨折组89例,年龄52~92[平均(75.7±9.3)]岁,均为脆性股骨颈骨折。非骨折组61例,年龄50~82[平均(61.2±9.9)]岁;疾病类型:27例为股骨头坏死继发髋关节骨性关节炎,34例为髋关节骨性关节炎。DXA BMD测量部位均为手术对侧(健侧)股骨近端,采用股骨颈BMD。结果骨折组的低骨量患者所占的比例(100%)与非骨折组(75.4%)比较有显著差异(P0.05);在骨折组与非骨折组中,骨量减少及骨质疏松(OP)的患者在男性中所占的比例与在女性所占的比例相比无显著差异(P0.05);所有患者BMD都是随着年龄的增大而降低,两者呈明显负相关(r=-0.514,P=0.000);骨折组[BMD(0.584±0.093)g/cm2],明显低于非骨折组[(0.701±0.156)g/cm2,P0.000];骨折组平均年龄[(75.7±9.3)岁]明显高于非骨折组[(61.2±9.9)岁,P=0.000]。结论初次髋关节置换的患者,不管是股骨颈骨折还是骨性关节炎或股骨头坏死的患者,不管是男性还是女性,大部分都处于低骨量的状态,应重视术前的BMD检测和术后的抗OP治疗。
[Abstract]:Objective to investigate the bone mineral density (BMD) of hip before primary hip replacement. Methods 150 patients were divided into two groups. 89 patients (mean (75.7 卤9.3) years old) in the fracture group were treated with fragile femoral neck fracture. 61 cases of non-fracture group, mean age of (61.2 卤9.9) years, type of disease: 27 cases were osteoarthritis of hip joint secondary to osteonecrosis of femoral head, 34 cases were osteoarthritis of hip joint. DXA BMD was measured in proximal femur of contralateral side (normal side). Results the proportion of patients with low bone mass in fracture group (100%) was significantly different from that in non-fracture group (75.4%) (P0.05). There was no significant difference in the proportion of male and female patients with osteopenia and osteoporosis (OP) (P0.05); BMD decreased with age in all patients. The average age of fracture group [(75.7 卤9.39) years] was significantly higher than that of non-fracture group [(61.2 卤9.99) years], and the mean age of fracture group [(0.584 卤0.093) g/cm2] was significantly lower than that of non-fracture group [(0.701 卤0.156) g / cm ~ (2) P _ (0.000)], and the mean age of fracture group [(75.7 卤9.3) years] was significantly higher than that of non-fracture group [(61.2 卤9.9) years old P _ (0.000)]. Conclusion most of the primary hip replacement patients, whether the femoral neck fracture, osteoarthritis or femoral head necrosis, whether male or female, are in a low bone mass state. Attention should be paid to preoperative BMD detection and postoperative anti-op therapy.
【作者单位】：福建医科大学附属第二医院骨科;
【分类号】：R687.4

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