前臂远端骨密度和singh指数预测骨质疏松性髋部骨折  

Forearm Bone Densitometry and Singh Index of the Femoral Trabecular Pattern for Predicting Osteoporotic Hip Fracture

作　　者：高铁军[1] 张光铂[1] 

机构地区：[1]北京中日友好医院骨科,100029

出　　处：《中华创伤杂志》1993年第1期17-19,共3页Chinese Journal of Trauma

摘　　要：用单光子骨密度仪测定前臂远端骨密度和股骨粗隆Singh指数评分法,对77例老年测试者骨质疏松进行了评价,并预测其骨质疏松髋部骨折的相对危险性。结果表明:前臂运端骨密度与股骨粗隆Singh指数有较好的正相关性(r=0.41)。前臂远端骨密度降低和Singh指数变小时,髋部骨折的相对危险性增加。当前臂远端骨面密度下降一个s(0.61g/cm^2)时,髋部骨折的相对危险性为1.54;下降4个s(0.32g/cm^2)时,髋部骨折的相对危险性为8.21。当Singh指数小于3时,髋部骨折的相对危险性为12。当前臂远端骨面A密度≤0.32g/cm^2或/和Singh指数小于等于3时,骨质疏松性髋部骨折的发生率有显著性差异。我们认为,以上两个参数可作为骨质疏松性髋部骨折发生的危险阈值和应采取必要的预防、治疗措施的标准。两种方法结合,能够更可靠地评价髋部骨质疏松的程度和骨质疏松性髋部骨折发生的相对危险性。前臂远端骨密度较Singh指数更敏感地反映了髋部骨量的变化。In this retrospective study, osteoporosis in 77 elderly persons, including 22 cases of hip fractures, were evaluated and the relative risk of the osteoporotic hip fracture was predicted by bone densitometry at the distal forearm and Singh index of the femoral trabecular pattern. The results showed that there was a close correlation between forearm bone density and Singh index at hip (r=0.41). The risk of hip fracture was inversely related to the forearm bone density and Singh index. The relative risk ofhip fracture was 1.54 for a decrease of 1s (BMD=0.61g/cm^2 ) in the bone density (95% confidence interval, 0.49-4.85), 8.21 for a decrease of 4s (BMD=0.32g/cm^2)in bone density (95% confidence interval, 0.81-83.90) and 12 for singh index below 3 (95% confidence interval, 3.86-38.90). The incidence rate of hip fracture was statistically a significant difference when the forearm bone density was less than 0.32 g/cm^2 and /or Singh index was below 3. We conclude that decreased bone density in the appendicular skeleton is associated with an increased risk of hip fracture among elderly persons. The bone density at the distal forearm ≤0.32g/cm^2 and/or Singh index≤3 should be considered as the risk threshold of osteoprotic hip fracture. The forearm bone densitometry combined with Singh index predicts osteoporotic hip fracture more reliable than that of using only one technique. Single-photon absorptiometry of forearm appears to be a useful tool for screening normal populations of asymptomatic older persons for prediction of hip fracture risk.

关 键 词：骨质疏松 骨密度 髋部骨折 

分 类 号：R683.3[医药卫生—骨科学]