小儿炎症性肠病定量CT骨密度测量的研究

发布时间：2018-10-11 19:01

【摘要】：目的应用定量CT(QCT)评估小儿炎症性肠病(inflammatory bowel disease,IBD)的骨密度(bone mineral density,BMD)状况,为IBD的治疗提供依据。方法收集我院确诊的IBD患儿27例,同时收集正常人群62例。应用QCT方法测量两组人群骨密度,结果进行统计学分析。同时从中选取学龄儿童(7~12岁)的IBD患儿共12例作为病例组;按照性别、年龄、人数相匹配的原则从正常人群中选取12例作为正常对照组。对这两组的QCT结果进行统计学分析。并观察这两组对照结果的一致性。结果 1)0~14岁27名IBD患儿骨密度从110.9mg/cm3到201.8mg/cm3,骨密度平均值为(165.49±18.93)mg/cm3,与62名正常人群骨密度值的比较(IBD患儿低于正常人群骨密度的平均值(189.65±26.99)mg/cm3,Z=-4.07,P=0.000,P0.05,二者差异有统计学意义;2)克罗恩病(Crohn’s disease,CD)组患儿骨密度平均值(162.26±16.77)mg/cm3,与正常人群骨密度比较(CD组患儿低于正常人群骨密度的平均值(189.65±26.99)mg/cm3,Z=-3.261,P=0.001,P0.05,二者差异有统计学意义。溃疡性结肠炎(ulcerative colitis,UC)组患儿骨密度平均值(171.97±17.11)mg/cm3,与正常人群骨密度比较〔UC组患儿低于正常人群骨密度的平均值(189.65±26.99)mg/cm3〕,Z=-1.908,P=0.056,P0.05,二者差异无统计学意义;3)病例组(12名7~12岁IBD患儿)的骨密度与正常对照组(12名7~12岁正常儿童)骨密度的比较:病例组骨密度平均值为(159.9±15.32)mg/cm3,正常对照组骨密度平均值为(186.96±10.97)mg/cm3,t=-4.97,P=0.000,P0.05,二者差异有统计学意义,且病例组骨密度低于正常对照组的骨密度。结论 IBD患儿骨密度低于同年龄正常人群骨密度;其中CD组和UC组患儿骨密度均低于正常人群骨密度,且CD组患儿比UC组患儿更易出现骨密度下降。使用QCT骨密度测量技术可以精确敏感的评估患儿骨密度情况,指导临床进一步的治疗方案。
[Abstract]:Objective to evaluate the bone mineral density (bone mineral density,BMD) of inflammatory bowel disease (inflammatory bowel disease,IBD) by quantitative CT (QCT) and to provide evidence for the treatment of IBD. Methods 27 cases of IBD and 62 cases of normal population were collected. The bone mineral density (BMD) of the two groups was measured by QCT method, and the results were analyzed statistically. At the same time, 12 cases of school age children (7 ~ 12 years old) with IBD were selected as case group, and 12 cases of normal population were selected as normal control group according to the principle of gender, age and population matching. The QCT results of the two groups were statistically analyzed. The consistency of the control results between the two groups was observed. Results 1) the BMD of 27 IBD children aged 14 years was from 110.9mg/cm3 to 201.8mg / cm ~ (3), the average value of BMD was (165.49 卤18.93) mg/cm3, and 62 normal subjects (the BMD of IBD children was lower than that of normal subjects (189.65 卤26.99) mg/cm3,Z=-4.07,P=0.000,P0.05,; 2) Crohn's BMD was significantly lower than that of normal subjects (189.65 卤26.99) mg/cm3,Z=-4.07,P=0.000,P0.05,. The average value of BMD in Crohn's disease,CD group was (162.26 卤16.77) mg/cm3, compared with that in normal group (BMD in CD group was lower than that in normal group (189.65 卤26.99) mg/cm3,Z=-3.261,P=0.001,P0.05,). The mean value of BMD in children with ulcerative colitis (ulcerative colitis,UC) was (171.97 卤17.11) mg/cm3, compared with that in normal controls (BMD in UC group was lower than that in normal controls (189.65 卤26.99 mg/cm3), and there was no significant difference between the two groups. 3) there was no significant difference between the two groups (12 IBD children aged 712 years). BMD was compared with that in the normal control group (12 normal children aged 712 years): the average BMD in the case group was (159.9 卤15.32) mg/cm3, the average BMD in the normal control group was (186.96 卤10.97) mg/cm3,t=-4.97,P=0.000,P0.05, there was significant difference between the two groups. The BMD in the case group was lower than that in the normal control group. Conclusion the BMD of children with IBD is lower than that of normal people of the same age, the BMD of CD group and UC group is lower than that of normal group, and the BMD of CD group is more likely to decrease than that of UC group. QCT bone density measurement can accurately and sensitively evaluate the BMD in children and guide further clinical treatment.
【作者单位】：首都医科大学附属北京儿童医院影像中心;
【基金】：首都临床特色应用研究(项目编号:Z141107002514005)
【分类号】：R725.7;R816.92

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