老年女性髋部脆性骨折患者的Singh指数分析  

Singh index of hip X-ray in postmenopausal women osteoporotic hip fracture

作　　者：李新民[1] 侯雪[1] 苏永彬[1] 张勇[1] 程晓光[1] 

机构地区：[1]北京积水潭医院放射科,北京100035

出　　处：《中国医学影像技术》2015年第10期1479-1482,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京市卫生系统高层次卫生技术人才培养项目(2009-02-03);首都卫生发展科研专项自主创新项目(首发2014-2-112);首都临床特色应用研究项目(z141107002514072)

摘　　要：目的探讨Singh指数在老年女性髋部脆性骨折患者骨密度评估中的应用价值。方法将216例老年女性髋部脆性骨折患者按年龄分为4组,60-70岁组53例,71-80岁组83例,81-90岁组68例,〉90岁组12例。行髋部X线摄影,评估患者健侧Singh指数,并将Singh指数≤Ⅳ级作为骨质疏松诊断标准。分析2名诊断医师间隔1个月前后两次评估Singh指数分级的一致性;比较各年龄组患者身高、体质量及体质量指数（BMI）及Singh指数的差异;并评价髋部Singh指数与患者年龄、BMI的相关性。结果 2名医师评估Singh指数分级的观察者内Kappa值分别为0.631、0.615,观察者间Kappa值分别为0.622、0.598。应用Singh指数诊断骨质疏松的总体检出率为89.35%（193/216）。各年龄组患者身高、体质量及BMI差异均无统计学意义（P均〉0.05）,Singh指数差异有统计学意义（H=56.077,P〈0.001）。Singh指数与患者年龄呈负相关（r=-0.656,P〈0.001）,与BMI无相关性（r=-0.008,P=0.902）。结论 X线平片Singh指数虽然相对经济、简便且较为实用,但重复性较低,不能完全反映老年女性脆性骨折患者骨密度情况。Objective To investigate the clinical value of Singh index（SI）in evaluating bone density of osteoporotic hip fracture in postmenopausal women.Methods A total of 216 postmenopausal women with osteoporotic hip fracture were divided into 4groups according to age.There were 53 cases in 60—70years group,83 cases in 71—80years group,68 cases in 81—90years group and 12 cases in90years group.Digital pelvic radiographs were received to evaluate SI of the nonfractured side femur and SI≤Ⅳ was considered as the diagnostic standard of osteoporosis.The consistency of the results in evaluating SI for 2times with interval of a month between 2radiologists was analyzed.The differences of height,weight,body mass index（BMI）and femur SI were compared among groups.The correlations among SI,age and BMI were studied.Results The intra-and inter-observer variations of SI grading were 0.631,0.615 and 0.622,0.598,respectively.The detection rate of osteoporosis using femur SI was 89.35%（193/216）.There was no statistical difference of height,weight and BMI among different groups（all P〉0.05）,while statistical difference of femur SI was found（H=56.077,P〈0.001）.The results of SI were negatively correlated with age（r=-0.656,P〈0.001）,while there was no significant correlation between SI and BMI（r=-0.008,P=0.902）.Conclusion The detection of SI for the diagnosis of osteoporosis is inexpensive,simple and practical,but the intra-and inter-observer agreement assessment of SI are generally poor,and SI can not reflect bone density accurately.

关 键 词：SINGH指数 骨质疏松 骨折 骨 髋部 

分 类 号：R683[医药卫生—骨科学] R814[医药卫生—外科学]