双能X线和单光子吸收法及定量超声诊断骨质疏松症的比较  

Comparison of dual energy X-ray absorptiometry, single photon absorptiometry and quantitative ultrasound for diagnosis of osteoporosis

作　　者：伍贤平[1] 廖二元[1] 周智广[1] 黄干[1] 邓小戈[1] 彭健[1] 

机构地区：[1]湖南医科大学附二医院代谢内分泌研究所

出　　处：《中国骨质疏松杂志》1997年第4期11-14,共4页Chinese Journal of Osteoporosis

基　　金：卫生部临床学科重点项目

摘　　要：了解三种方法诊断骨质疏松症（ＯＰ）之间的关系。方法应用双能Ｘ线吸收法（ＤＸＡ）和单光子吸收法（ＳＰＡ）及定量超声（ＱＵＳ），同时随机测量２９４例受试者腰椎后前位和侧位、左侧髓部和前臂骨矿密度（ＢＭＤ）及右侧胫骨超声速度（ＳＯＳ）。结果ＤＸＡ和ＳＰＡ测量桡骨ＯＰ的检出率分别为２５．９％和２１．４％，ＤＸＡ测量腰椎后前位、侧位、侧位兴趣区、Ｗａｒｄ’ｓ区和股骨颈ＯＰ检出率分别为１６．０％、２２．８％、２６．２％、１９．４％和４．４２％，ＱＵＳ的ＯＰ检出率为１７．７％。三种方法及不同部位之间的测量结果呈显著相关（ｒ＝０．４９４～０．９６７，Ｐ＜０．０１）。ＤＸＡ测量前臂１／３处ＢＭＤ显著高于ＳＰＡ。诊断ＯＰ的齐同率ＤＸＡ各部位相互之间平均为４０．１％±１５．５％，ＤＸＡ与ＳＰＡ平均为４８．４％±１９．０％，ＱＵＳ与ＤＸＡ和ＳＰＡ平均为３８．８％±１０．２％，各平均值之间无显著差异。结论ＯＰ的检出率取决于受检部位，腰椎侧位兴趣区和挠骨是检出率最高的部位，股骨颈和尺骨是最低的部位。ＳＰＡ与ＤＸＡ测量前臂ＢＭＤ高度相关，诊断结果无显著性差别。Purpose:To understand the relationship between the results obtained by three methods in the diagnosis of osteoporosis (OP). Methods: Bone mineral density(BMD) at anteroposterior and lateral spine,left hip and forearm was measured by dual energy X-ray absorptiometry(DXA),BMD of left forearm by single photon absorptiometry(SPA) and speed of sound (SOS) at right tibia by quantiative ultrasound (QUS) in 294 subjects. Results:The detectable rates of OP were 25. 9% and 21. 4% at the radius by DXA and SPA, 16. 0%, 22. 8%, 26. 2 %, 19. 4 % and 4. 42 % at the anteroposterior spine,lateral spine and region of interest, Ward' s triangle and femoral neck by DXA,and 17. 7% at the tibia by QUS, respectively. There were significant correlations (r=0.494-0. 967,p<0.01) between the results measured at each site by the three methods. BAD at forearm by DXA was significantly higher than by SPA. The mean homogeneity rates of the diagnosis of OP were 40.1%±15.5% between sites by DXA,48.4 %±19.0% between DXA and SPA,and 38.8%±10.2% between QUS and DXA, SPA,respectively. No significant difference was found between mean homogenlity rates. Conclusion: The detectable rutes of OP were closely correlated with skeletal sites and it was highest at the region of interest of lateral spine and radius,and lowest at the femoral neck and ulna. There were highly significant correlations in BMD at forearm measured by DXA and SPA,and no significant difference was found in diagnostic results.

关 键 词：DXA 诊断 OP 检出率 QUS 单光子吸收法 BMD 骨质疏松症 定量超声 断骨 

分 类 号：R681[医药卫生—骨科学] R446.9[医药卫生—外科学]