中老年男性雄激素部分缺乏患者骨密度测定的临床价值  

Clinical value of bone densitometry in partial androgen deficiency in aging male patients

作　　者：尹纪军[1] 王建然[1] 杨荣[1] 王青[1] 单文辉 高波[3] 

机构地区：[1]山东省日照市人民医院骨科,276800 [2]山东省日照市妇女儿童医院骨科 [3]济宁医学院日照校区

出　　处：《中国医师进修杂志》2011年第5期28-31,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨中老年男性雄激素部分缺乏（PADAM）患者的骨密度（BMD）特点和骨质疏松的发生率。方法采用双能X线骨密度仪对56例PADAM患者（PADAM组）和与之年龄、体重指数（BMI）相匹配的51例健康中老年人（对照组）进行腰椎及股骨颈等部位的BMD测定，采用MES-01S20肌肉功能分析仪测定肌肉分布和力学特性，并收集相关生化指标、激素水平及部分骨代谢指标进行多元逐步回归分析。结果与对照组比较，PADAM组腰椎BMD无显著改变（P〉O．05），而股骨颈、Ward三角区和大转子的BMD显著降低（P〈0．01），且其抗骨折能力和下肢最大肌力显著降低（P〈0．01）。PADAM组和对照组的骨量减少发生率分别为48．2％（27／56）和35．3％（18／51），骨质疏松患病率分别为30．4％（17／56）和21．6％（11／51），两组比较差异有统计学意义（P〈0．05）。PADAM患者的腰椎BMD与BMI呈正相关，而股骨颈、Ward三角区、大转子的BMD与年龄呈负相关，与BMI、血清总睾酮呈正相关（P〈0．05）。结论PADAM患者的BMD及抗骨折能力明显降低，存在骨质疏松性骨折的潜在危险，加强PADAM患者骨折的预防和治疗有重要意义。Objective To explore the characteristics of bone mineral density （BMD） and the incidence of osteoporosis in partial androgen deficiency in aging male （PADAM） patients. Methods Fifty-six PADAM patients （PADAM group ） and 51 healthy persons （control group） were selected according to their age and body mass index （ BMI ）, and measured their BMD in the second to fourth lumber and the neck of femur with the dual-energy C X-ray BMD measuring instrument. MES-01S20 muscle function analyzer was used to determinate the distribution and mechanical properties of muscle. The biochemical and bone metabolic markers and sexual hormones were collected and observed by multivariate stepwise regression analysis. Results Compared with control group, BMD significantly decreased in the Ward triangle, femoral neck and big rotor （P 〈 0.01 ） and no significant change in lumbar in PADAM group （P 〉 0.05 ）, and the fractnre strength of femoral neck （FS） and the lower-limb muscular strength （MS） also significantly decreased （P 〈 0.01 ）. The incidence of osteopenia were 48.2% （ 27/56 ） and 35.3% （ 18/51 ）, osteoporosis were 30.4% （17/56） and 21.6% （ 11/51 ） respectively in PADAM group and control group. There was significant difference between two groups （P 〈 0.05 ）. The BMD was positively correlated to BMI at/he first to fourth lumber and negatively correlated to age,positively correlated to BMI and serum level of andrusol at the proximal left femur in the patients with PADAM. Conclusion BMD and the resistance to fracture are significantly lower in PADAM patients, and aging lower BMI and androgen deficiency are the risk factors of low BMD in PADAM patients. There is the potential of osteoporotic fracture risk, and it is important to strengthening the prevention and treatment of fractures in elderly PADAM patients.

关 键 词：骨密度 雄激素类 骨质疏松 骨折 部分性雄激素缺乏 

分 类 号：R580[医药卫生—内分泌]