高铝高氟骨变形患者骨质改变的显微CT检查结果分析  

Analysis of bone micro-CT results of patients with bone deformation exposed to high aluminum high fluoride

作　　者：李福成 高凯 丛旭滋[1] 颜书林[1] 

机构地区：[1]贵州省六盘水市疾病预防控制中心地方病科,553001 [2]中国医学科学院医学实验动物研究所

出　　处：《中华地方病学杂志》2014年第5期561-564,共4页Chinese Journal of Endemiology

基　　金：贵州省六盘水市科技局项目（52020-2007-006）

摘　　要：目的 分析高铝高氟骨变形患者骨质改变的显微CT检查结果.方法 在贵州省水城县农村勺米乡与纸厂乡结合部燃煤污染型地方性氟中毒（简称地氟病）病区,以骨变形儿童、青年、中年氟骨症患者作为病例组观察对象,同时以病区非骨变形儿童、青年,以及非病区儿童作为对照.通过矫形手术和病因学检查获得髂前上棘和胫骨上段骨组织,进行不脱钙树脂包埋.采用显微CT检查扫描树脂包埋的骨组织,用ABA专用骨骼分析软件INVEON reseach workplace和Micview三维重建处理软件分析相关参数.结果 ①髂前上棘松质骨：病区骨变形儿童与病区非骨变形儿童比较,骨小梁相对体积（0.337％比0.229％）、绝对厚度（μm：139比133）、单位长度内骨小梁的数量（个/mm：2.44比1.72）、骨小梁密织度（个/mm：2.22比1.54）和骨矿密度（mg/cm3：1 033比918）均有增高趋势,而骨小梁相对骨面积（mm2/mm3：14.5比15.1）、空间间距（μm：0.274比0.567）有降低趋势.病区骨变形青年与病区非骨变形青年比较,骨小梁相对体积较低（0.217％比0.437％）,相对面积增加（mm2/mm3：16.9比11.6）,绝对厚度降低（μm：118比172）,单位长度内的骨小梁数量减少（个/mm：1.83比2.54）,空间间距增大（μm：0.427比0.222）,但骨小梁密织度增加（个/mm：4.61比1.54）,骨矿密度下降（mg/cm3：977比1 108）,呈骨量减少、骨质疏松、骨矿减少,骨小梁交叉数量增多的细疏结构.②胫骨上段骨组织：病区骨变形儿童与非病区儿童比较,胫骨上段密质骨骨小梁相对体积增高（0.435％比0.206％）,骨小梁相对面积（mm2/mm3：12.3比12.4）、绝对厚度（μm：188比161）改变不明显,单位长度内的骨小梁数量增加（个/mm：2.43比1.28）,空间间距减小（μm：0.238比0.621）,骨小梁密织度减少（个/mm：2.40比3.48）,骨矿密度增加（mg/cm3：1 047比952）,呈骨小梁增粗、数量增�Objective To analyze high alumina deformation Micro-CT findings of bone in patients with skeletal fluorosis in Shuicheng Guizhou Province.Methods Bone deformation children,youth and middle-aged patients with fluorosis in Goumi and Zhichang Townships Shuicheng County,coal-burning pollution endemic fluorosis areas,were selected as case group,and non-bone deformation children,youth,and children from non-fluorosis endemic areas as controls.Tibia and the anterior superior iliac spine tissue were obtained through orthopedic surgery and etiology examination,and resin embedded without decalcification.Resin-embedded bone tissue was scanned using micro-CT; relevant parameters were analyzed with ABA special bone analysis software INVEON Research Workplace and three dimensional reconstruction processing software Micview.Results ①The anterior superior iliac spine cancellous bone：compared between bone deformation children and bone non-deformation children in the diseased areas,there was an increasing tendency of the following items：relative volume of trabecular bone（0.337% vs 0.229%）,absolute thickness （μm：139 vs 133）,quantities within a unit length （number/mm：2.44 vs 1.72）,density woven degree of trabecular bone（number/mm：2.22 vs 1.54） and bone mineral density（mg/cm3：1 033 vs 918）,while relative bone area of trabecular bone（mm2/mm3：14.5 vs 15.1） and space pitch （μm：0.274 vs 0.567） declined.Compared between bone deformation youth and bone non-deformation youth in the diseased areas,relative volume of trabecular bone was lower（0.217% vs 0.437%）,relative area increased （mm2/mm3：16.9 vs 11.6）,absolute thickness reduced（μm：118 vs 172）,trabecular number reduced （number/mm：1.83 vs 2.54）,and space pitch increased （μm：0.427 vs 0.222）,but density woven degree of trabecular bone increased （number/mm：4.61 vs 1.54）,bone mineral density decreased（mg/cm3：977 vs 1 108）,osteopenia,osteoporosis,bone mineral decreased,and an increase in the number of trabe

关 键 词：铝 氟化物中毒 骨软化症 骨质 

分 类 号：R599.1[医药卫生—内科学]