双能X线吸收与定量CT对比评价北京地区中老年女性与年龄相关的骨丢失  

Comparison of quantitative computed tomography and dual-energy X-ray absorptiometry:Age-related bone loss of women in Beijing

作　　者：李娜[1] 唐海[2] 张勇[1] 李大胜[3] 吴丹 冯强强[1] 蔡韦[1] 王仲朴[3] 张天辉[3] 覃革荣 马骥良 程晓光[1] 

机构地区：[1]北京积水潭医院放射科,北京100035 [2]首都医科大学附属北京友谊医院骨科,北京100050 [3]北京市海淀医院放射科,北京100080 [4]北京市老年病医院放射科,北京100029 [5]西斯比亚(北京)医药技术研究有限责任公司,北京102206

出　　处：《中国医学影像技术》2015年第10期1487-1491,共5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(2014-2-112);首都临床特色应用研究项目(z141107002514072)

摘　　要：目的采用双能X线吸收（DXA）和定量CT（QCT）对比评价北京地区中老年女性骨密度与年龄相关的骨丢失。方法收集北京地区接受腰椎正位及髋部DXA检查（面积骨密度测量）的社区女性10 472名,接受腰椎QCT检查（体积骨密度测量）的女性562名。将接受两种检查的受检者分别按每10岁年龄段分组。计算各组别的平均骨密度,并计算峰值骨密度各组别的骨丢失率,分析骨密度与年龄间的相关性。结果 DXA测量北京地区女性腰椎、股骨颈及全髋部的峰值骨密度均在30-39岁年龄组,40岁以后各部位骨密度开始不同程度减低,至80-94岁组腰椎、股骨颈、全髋部累计骨丢失率分别为21.7%、31.4%和29.5%;QCT测量腰椎松质骨的峰值骨密度在20-29岁组,至80-97岁组累计骨丢失率达58.2%。累计骨丢失率从高到低依次为腰椎松质骨〉股骨颈〉全髋部〉腰椎正位。结论腰椎QCT可较DXA更早、更准确地显示中老年女性的骨丢失情况,对增龄性骨丢失更敏感。Objective To compare the differences of age-related bone loss of women in Beijing between dual-energy X-ray absorptiometry（DXA）and quantitative computed tomography（QCT）.Methods Bone mineral density（BMD）data of female Beijing residents were collected.Areal BMD（aBMD）of the lumbar spine and hip was measured by DXA in 10 472 women.Trabecular volumetric BMD（vBMD）of lumbar vertebrae was measured by QCT in 562 women.Each group was divided into several groups according to the age of every 10 years.Average BMD of each group and bone loss rate was calculated.Linear correlation analysis between BMD and age was analyzed.Results The peak aBMD of the lumbar spine,femoral neck and total hip in female Beijing residents occurred in 30—39years group.The aBMD of each site decreased after the age of 40 years.And in the 80—94years group,aBMD decreased by 21.7%,31.4% and 29.5%,respectively.The peak vBMD of lumbar spine occurred in 20—29years group.Decrease in trabecular vBMD was 58.2%in 80—97years group.Linear correlation of bone loss with age：Lumbar spine trabecular bone〉femoral neck〉total hip〉lumbar spine.Conclusion QCT may be more sensitive and accurate to detect the bone loss in elderly women than DXA,and may be more sensitive to reflect the age-related bone loss.

关 键 词：骨丢失 骨密度 体层摄影术 X线计算机 X线 

分 类 号：R3[医药卫生—基础医学] R814.42