定量CT测量强直性脊柱炎患者髋臼骨密度  

Quantitative CT in measuring acetabular bone mineral density in patients with ankylosing spondylitis

作　　者：陈芳妮[1] 李绍林[1] 严杰文[1] 韩新爱[2] 石星亮[2] 

机构地区：[1]南方医科大学第三附属医院医学影像中心,广州510630 [2]南方医科大学第三附属医院风湿免疫科,广州510630

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2014年第4期314-319,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的探讨定量CT（QCT）测量成年男性强直性脊柱炎（AS）患者髋臼骨密度（BMD）的价值,研究此类患者髋臼骨量变化。方法选取25例经临床确诊的成年男性AS患者为志愿者,年龄20-44岁,平均（28.6±7.1）岁。分别行双侧髋关节（50个）双能X线吸收仪（DXA）和QCT检查。按照全髋部DXA测定结果,将Z值≤-2.0S的27个髋关节设为试验组,Z值〉-2.0S的23个髋关节设为对照组,比较2组髋臼坐骨体、耻骨体和髂骨体BMD的差异。结果试验组耻骨体、坐骨体BMD值分别为（71.965±35.695）、（87.093±38.413）mg/cm^3,显著低于对照组的（110.526±62.466）、（121.883±39.380）mg/cm^3,差异有统计学意义（P〈0.05）,试验组髂骨体BMD（156.822±41.472）mg/cm^3与对照组（177.948±55.804）mg/cm^3差异无统计学意义（P〉0.05）;AS患者髋臼髂骨体BMD均显著高于坐骨体和耻骨体BMD（均P〈0.05）;AS患者坐骨体和耻骨体BMD差异无统计学意义（P〉0.05）。结论QCT可敏感地反映髋臼不同部位BMD变化。AS患者髋臼的坐骨体、耻骨体较髂骨体更易出现骨密度减低。Objective To evaluate the QCT in measuring acetabular BMD of the adult male with ankylosing spondylitis,and to study the change of acetabular metabolism of these patients. Methods Twenty-five adult male patients（ range 20- 44 years,mean age,28. 6 ± 7. 1 years） with AS by clinical confirmed were underwent DXA and QCT in bilateral hip,separately. According the BMD results of total hip on DXA,twenty-seven hip Z-score of- 2. 0 or below as experimental group,and twenty-three totl hip Z-score as control group. Then we compare the difference of BMD in ischium,pubic and ilium between the two groups. Results The BMD in ischium and pubic of experimental group [（ 87. 093 ± 38. 413） and（ 71. 956 ± 35. 695） mg / cm^3]was lower than that in control group[（ 121. 883 ± 39. 380） and（ 110. 526 ± 62. 466） mg /cm^3],with significant difference（P〈0. 05）. However,no significant difference of BMD was found in ilium between the experimental group [（ 156. 822 ± 41. 472） mg / cm^3]and control group [（ 177. 948 ± 55. 804） mg / cm^3]（ P〉0. 05）. The BMD in ischium and pubic of both groups was significantly higher than that in ilium（ P〉0. 05）. There was no significant difference of BMD in ischium and pubic of both groups（ P〉0. 05）. Conclusion QCT can be used to test the change of BMD in acetabulum sensitively. The ischium and pubic of acetabulum in patients with AS was vulnerable to osteopenia.

关 键 词：强直性脊柱炎 髋臼 骨密度 定量CT 双能X线吸收仪 

分 类 号：R681[医药卫生—骨科学]