桡骨单光子骨密度测定与跟骨X射线摄片诊断骨质疏松比较  

Single photon absorptiometry and calcaneum radiography for diagnosis of osteoporosis

作　　者：杨华章[1,2] 邝建[1,2] 王敏霓[1,2] 王声涌[1,2] 崔长安[1,2] 刘国宁[1,2] 

机构地区：[1]广东省人民医院内分泌科 [2]广东省暨南大学医学院预防医学教研室

出　　处：《中国骨质疏松杂志》1999年第2期13-17,共5页Chinese Journal of Osteoporosis

摘　　要：目的了解、比较桡骨单光子骨密度测定与跟骨Ｘ射线摄片两种方法在骨质疏松诊断中的作用。方法随机抽取５４６名（女２６７名，男２７９名）４５岁以上中老年知识分子做非优势侧桡骨单光子骨密度测定与跟骨Ｘ射线摄片，分析桡骨骨密度（ＢＭＤ）及跟骨小梁Ｊｈａｍａｒｉａ分级的相关性；比较两种方法的诊断一致性。结果①桡骨ＢＭＤ及跟骨Ｊｈａｍａｒｉａ分级均随年龄增长而逐渐下降。②跟骨Ｊｈａｍａｒｉａ分级越高，桡骨ＢＭＤ也越高，两者的相关性女性为０．３８０（Ｐ＝０．０００１）；男性为０．１５０（Ｐ＝０．０１１）。③桡骨ＢＭＤ低于峰值－２ＳＤ的女性，跟骨Ｊｈａｍａｒｉａ分级１～２级占６１．８％，４～５级占３．５％，男性分别为３１．４％和７％；跟骨小梁Ｊｈｍａｒｉａ分级１～２级的人群中，６３．５％的女性桡骨ＢＭＤ＜峰值－２ＳＤ，男性仅为３９．７％；④分别以桡骨ＢＭＤ低于峰值－２ＳＤ和跟骨Ｊｈａｍａｒｉａ分级１～２级分别作为骨质疏松诊断标准，女性组的诊断一致性（Ｋａｐｐａ值）为０．３３８，男性组仅为０．１０８。结论女性人群的跟骨小梁Ｊｈａｍａｒｉａ分级与桡骨ＢＭＤ有较好的相关性，两者的变化在一定程度上可相互映证，而男性这种关系不明显。由于?Objective\ To understand the relationship between the results obtained by calcaneum radiograpghy and single photon absorptiometry(SPA)in the diagnosis of osteoporosis. Methods We studied 546 intellectuals(female:n=267,male:n=279)aged 45 years and older who had measurements of mineral density using SPA in distal radius and underwent calcaneum radiography classified by Jhamaria's method.Results 1.Distal radius bone density(rBMD)and calcaneum Jhamaria's grade were gradually lowered with age.2.The Jhamria's grade was significantly and positively associated with rBMD(female: r =0 380, P =0 0001;male: r =0 150, P =0 011).3.In the rBMD<PBD-2SD group,grade 1-2 accounted for 61.8%,grade 3 for 34.7% and grade 4-5 for 3.5% in females,31.4%,61.6% and 7.0% in the males ,respectively;in the grade 1-2 group,rBMD<PBD-2SD constituted 63.5% in females,and 39.7% in males.4.Using rBMD<PBD-2SD and Jhamaria's grade 1,2 as diagnostic criteria,the conformity observed was 67.4% in females and 64.2% in males,but Kappa value was 0 338 in females and 0.108 in males.[WTHZ]Conclusion The Jhamaria's grade is significantly and positively associated with rBMD ,and the two methods have appropriate diagnostic conformity in females but not in males.The diagnostic efficiency of SPA is better whan that of calcaneum radiography,especially in males,and can be increased through combination with the latter.

关 键 词：桡骨 跟骨 诊断 BMD 骨密度 骨质疏松 X射线摄片 单光子 骨小梁 男性 

分 类 号：R681[医药卫生—骨科学] R683[医药卫生—外科学]