骨质疏松性股骨粗隆间骨折类型与骨密度关系及临床意义  

Relationship of bone mineral density and type of intertrochanteric fracture in osteoporotic patient and its clinical significance

作　　者：沈宇辉[1] 袁高翔[1] 郁健[1] 王亚梓[1] 万荣[1] 徐建强[1] 张伟滨[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院骨科,200025

出　　处：《国际骨科学杂志》2011年第6期389-391,共3页International Journal of Orthopaedics

基　　金：上海市科委重点科技攻关项目(08411950600)

摘　　要：目的通过检测骨质疏松性股骨粗隆间骨折病人腰椎和髋部骨密度(BMD),探索骨折严重程度与骨质疏松严重程度之间的关系。方法回顾性研究骨质疏松性股骨粗隆间骨折患者108例,女性71例,男性37例;平均年龄72.77±12.92岁;体重60.20±12.10 kg;身高164.35±10.28 cm。按Evans分型,Ⅰa、Ⅰb型为A组(57例),Ⅰc、Ⅰd型为B组(51例)。所有病人均在骨折手术前接受双能X线骨密度仪(DXA)检测健侧髋部及腰椎BMD值并计算T值,比较分析两组间不同部位BMD和T值是否存在差异,并由此分析股骨粗隆间骨折类型与BMD之间的关系。结果 A、B两组在身高、体重、性别上无显著性差异(P>0.05),但腰椎(L1～4)、健侧髋部、股骨粗隆间、Ward三角区、股骨颈、股骨干的平均BMD值,A组分别为1.03±0.21、0.79±0.13、0.65±0.12、0.66±0.15、0.74±0.13、0.88±0.14,平均T值(除股骨干外)分别为-0.94±1.71-、1.19±1.08-、1.09±1.02、-1.78±1.14-、1.52±0.99;B组平均BMD值分别为0.90±0.12、0.70±0.10、0.58±0.09、0.52±0.12、0.64±0.10、0.81±0.13,平均T值(除股骨干外)分别为-2.20±0.98-、1.90±0.84-、1.79±0.78-、2.74±0.93-、2.33±0.76。A组BMD值和T值均高于B组,A、B两组BMD值和T值(除股骨干外)存在显著性差异(P<0.05)。结论骨质疏松性股骨粗隆间骨折严重程度与病人BMD降低程度相关。Evans分型不仅反映了股骨粗隆间骨折的严重程度,也反映了骨质疏松骨骨质量受损程度,在决定治疗方案时需予以充分考虑。Objective To clarify the relationship of the severity between osteoporosis and intertrochanteric fracture via measurement of bone mineral density(BMD) at lumber and hip on osteoporotic patients.Methods One hundred and eight elderly patients suffered with osteoporotic intertrochanteric fractures were retrospectively analyzed.There were 71 females and 37 males patients,and the average age,body weight and height were 72.77±12.92 y,60.20±12.10 kg and 164.35±10.28 cm,respectively.According to Evans classification system,Evans Ⅰa and Ⅰb two subtypes were defined as Group A(57 cases),and Evans Ⅰc and Ⅰd group B(51 cases).All patients received the bone densitometry(DXA scanning) examinations at lumbar vertebra and contralateral hip.The difference between two groups at BMD and T score was evaluated to clarify the relationship of the severity between osteoporosis and intertrochanteric fracture.Results There were no significant differences in the sex,weight and height between two groups(P>0.05),but the average age of group A was lower than group B.In group A,the average BMD of the lumbar vertebra(L1-4),whole contralateral hip,intertrochanteric region,Ward region,neck and shaft of the femur were 1.03±0.21,0.79±0.13,0.65±0.12,0.66±0.15,0.74±0.13,0.88±0.14,and the T scores(in addition to shaft of the femur) were-0.94±1.71,-1.19±1.08,-1.09±1.02,-1.78±1.14,-1.52±0.99,respectively.In group B,the average BMD of same region were 0.90±0.12,0.70±0.10,0.58±0.09,0.52±0.12,0.64±0.10,0.81±0.13,and T scores were-2.20±0.98,-1.90±0.84,-1.79±0.78,-2.74±0.93,-2.33±0.76,respectively.The average BMD and T score of patients in group A were higher than those in group B with significant difference between two groups(P<0.05).Conclusions The severity of lower BMD and T score are related with the severity of intertrochanteric fracture in osteoporotic patient.The results of the study suggest that Evans classification not only reflects the severity of the osteoporotic intertrochanteric fracture,but also the impaired qua

关 键 词：骨质疏松 股骨粗隆间骨折 骨折类型 骨密度 

分 类 号：R687.3[医药卫生—骨科学]