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目的 探讨老年人腰椎和髋部双能X线骨密度 (DEXA)测定T评分的一致性及髋部骨密度 (BMD)T评分在骨质疏松诊断中的意义。 方法 在排除患有影响骨量的疾病及使用影响骨代谢药物者后 ,选择 6 0～ 89岁老年人 2 6 0 (其中男 12 3人 ,女 137人 )例作为为研究对象。受检者均接受问卷调查、胸腰段脊椎正侧位X线摄片 ,DEXA测定 2～ 4腰椎 (L 2～ 4)椎体前后位和左髋部BMD(若左髋部发生过骨折或存有明显病变则改测右髋部 ) ,并进行有关统计分析。 结果 老年男性各年龄组L2～ 4BMDT评分比髋部要高 (P <0 0 1或P <0 0 5 ) ;老年女性除在 6 5～ 6 9岁、85～ 89岁年龄组腰椎BMDT评分比髋部要高 (P <0 0 1和P <0 0 5 )外 ,其余各组则差异无显著性。按照WHO标准 ,以髋部、腰椎和同时以髋部、腰椎BMDT评分为依据 ,在 12 3例男性中 ,分别有 19、6、5人被诊断为骨质疏松症 ;在 137例女性中 ,则分别有 35、17、14人被诊断为骨质疏松症 ;单以腰椎和同时以髋部、腰椎BMDT评分为依据所检出的骨质疏松症患者人数均少于单以髋部BMDT评分为依据者 (P<0 0 1)。 结论 在老年人尤其是老年男性 ,其腰椎BMDT评分明显高于髋部 ,髋部BMDT评分在骨质疏松诊断中的意义更为重要。
Objective To investigate the consistency of T-scores measured by dual-energy X-ray absorptiometry (DEXA) in the lumbar spine and hip and the significance of hip bone mineral density (BMD) T score in the diagnosis of osteoporosis in the elderly. Methods After excluding the diseases that affected the bone mass and using the drugs that affected the bone metabolism, we selected 260 cases of elderly (range, 12 3 and 137 female) from 60 to 89 years as study subjects. Subjects underwent questionnaire surveys. The thoracolumbar spine was examined by lateral radiographs. DEXA was used to determine the anteroposterior position of the vertebral body between 2 and 4 lumbar vertebrae (L 2 ~ 4) and the left hip BMD (if left hip fracture or There are obvious lesions were changed to test the right hip), and the relevant statistical analysis. Results The score of L2 ~ 4BMDT was higher in the elderly men than in the hip (P <0.01 or P <0.05). The BMDT scores of the lumbar spine of the elderly women except the 65 ~ 69 and 85 ~ 89 age groups Hip was higher (P <0.01 and P <0 05), the rest of the groups was no significant difference. According to the WHO criteria, based on the hip, lumbar and hip BMDT scores at the same time, 19.6 and 5 were diagnosed as osteoporosis in 123 males, respectively; in 137 females, 35,17 and 14 were diagnosed as osteoporosis respectively. The number of patients with osteoporosis detected by lumbar spine and BMDT score based on hip and lumbar spine were all less than those measured by BMDT alone As the basis (P <0 0 1). Conclusion The BMDT score of lumbar spine in the elderly, especially in older men, is significantly higher than that in the hip. The significance of hip BMDT score in the diagnosis of osteoporosis is even more important.