DXA腰椎骨密度诊断评价超声诊断骨质疏松的阈值研究  

The threshold evaluation study of bone quantitative ultrasound to diagnose osteoporosis with dual x-ray absorptiometry

作　　者：金善循[1] 徐克惠[2] 王雪梅[2] 陈波[2] 徐家林[3] 

机构地区：[1]四川省妇幼保健院,成都610031 [2]四川大学华西二院,成都610041 [3]四川大学华西四院,成都610041

出　　处：《中国医刊》2005年第11期35-36,共2页Chinese Journal of Medicine

摘　　要：目的以金标准DXA对骨定量超声的实用性进行评价。方法对291例20～79岁的妇女,排除了继发性骨质疏松,同时做腰椎正侧位骨密度测定和用CM-100型超声骨密度仪做右跟骨SOS测量;用SOS不同的诊断阈值与DXAT≤-2.5的阈值的结果比较。结果SOS诊断阈值为T≤-2.5时,敏感度、特异度和准确度分别为13.46%、86.10%和60.14%;SOS的T≤-2.0时,敏感度、特异度和准确度分别为32.69%、67.38%和54.98%;SOS的T≤-1.0时,敏感度、特异度和准确度分别为64.42%、37.97%和47.42%。以SOS的T≤-2.0的敏感度、特异度和准确度较为适宜。当超声T≤-2.5则敏感度太低,反之T≤-1.0则误诊率高达62.03%且准确度也低。结论建议骨定量超声的诊断阈值为T≤-2.0较为适宜。Objective To assess the valuation of bone quantitative ultrasound in the diagnosis for osteoporosis with dual xray absorptiometry （DXA）and to provid a simple and convenience diagnosis method to the choice of clinical practice. Methods The bone mineral density （ BMD ） at PA lumbar vertebrae were measured by DXA and the speed of sound （SOS） at right calcaneus were measured by bone quantitative ultrasound apparatus（CM-100） meanwhile in 291 women aged between 20 to 79 years old, who hadn＇ t secondary osteoporosis . The various diagnosis thresholds of SOS were compared with the T≤ - 2.5 of DXA for osteoporosis. Results When the diagnosis threshold of SOS was T≤ - 2.5, the sensitivity ,the specificity and the accuracy was 13.46%, 86.10% ,60.14% respectively. When the diagnosis threshold of SOS was T≤ - 2, the sensitivity, the specificity and the accuracy was 32.69. %, 67.38% ,54.98% respectively. When the diagnosis threshold of SOS was T ≤ - 1 the sensitivity , the specificity and the accuracy was 64.42%, 37.97% ,47.42% respectively. So we think the SOS T≤ -2 for diagnosis is more suitable than T≤ -2.5 and T≤ - 1, which is too low for the sensitivity or too high for misdiagnosis rate. Conclusion It is more reasonable that the diagnosis threshold for osteoporosis with bone quantitative ultrasound is T≤ -2 ,which coincide with Black＇s study.

关 键 词：骨质疏松 定量超声 双能X线吸收法 阈值评价 

分 类 号：R684[医药卫生—骨科学]