股骨颈强度指数及骨髓脂质在评价骨质疏松性髋部骨折中的作用  

The effect of femoral strength index and marrow lipid fraction on the prediction of osteoporotic hip fractures

作　　者：李雪峰[1] 李冠武[1] 常时新[1] 周蕾[1] 王晶晶[2] 史晓[2] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院医学影像科,上海200437 [2]上海中医药大学附属岳阳中西医结合医院老年科,上海200437

出　　处：《中国骨质疏松杂志》2016年第2期163-165,175,共4页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金项目资助(81202809;81373856)

摘　　要：目的探讨股骨颈强度指数(FSI)及骨髓脂质分数(LF)在预测股骨颈脆性骨折风险中的价值。方法女性股骨颈骨折患者17例及正常对照组68例行DXA扫描获取股骨颈骨密度(FN_BMD)及FSI,MRS扫描获取LF。Bayes法建立股骨颈骨折判别方程,比较FSI及LF骨折风险判别效果。结果 LF与FN_BMD(r=-0.581)、FSI(r=-0.408)呈中度负相关(P均<0.05)。校正年龄、身高、体重、BMI,LF与FN_BMD、FSI相关性依然存在。校正上述混杂因素,骨折组FSI(1.10±0.16)较正常对照组(1.37±0.25)低,LF(79.2±16.4%)较对照组(57.9±16.8%)高(P均<0.05)。校正FN_BMD,FSI、LF在组间仍存在统计学差异。包含LF判别方程对骨折判别的敏感性、特异性分别为74.7%、68.4%,准确率为68.2%(自身回代法)、65.9%(交互校验法);包含FSI判别方程对骨折判别的敏感性、特异性分别为79.7%、76.9%,准确率为76.5%、72.9%。结论LF及FSI独立于BMD决定髋部骨强度的有用因子,MRS测定LF对预测髋部脆性骨折有一定价值。Objective To assess the predictive value of femoral strength index （FSI） and marrow lipid fraction （LF） in hip osteoporotic fractures. Methods DXA and MRS were performed to obtain femoral neck BMD （FN_BMD）, FSI, and LF in 17 women with hip fractures and 68 health controls. Bayes equation was used to compare the effect between FSI and LF in predicting the risk of hip fractures. Results LF was negatively correlated with FNBMD （ r = - 0. 581 ） and FSI （ r = - 0. 408, P 〈 0. 05）. The correlation remained statistically significant after adjusting age, height, weight, and BMI. FSI in fracture group （1.10 ± 0. 16） was lower than that in control group （ 1.37±0.25 ）. LF in fracture group （79.2± 16.4% ） was higher than that in control group （57.9 ± 16.8% ）. The differences of FSI and LF between groups remained significant after adjusting the confounders. Based on the discriminate equation, the sensibility and specificity for FSI to predict hip fracture risk was 74.7% and 68.4%, respectively. The accuracy was 68.2% （Self-Validation） and 65.9% （Cross-Validation）, respectively. The sensibility and specificity for FSI to predict hip fracture risk was 79.7% and 76. 9% , respectively. The accuracy was 76. 5% and 72. 9% , respectively. Conclusion Both LF and FSI are the predictors of hip bone strength independent of FN_BMD. LF may be valuable in the evaluation of fragile fractures.

关 键 词：骨质疏松 股骨颈骨折 股骨颈强度指数 骨髓脂肪 

分 类 号：R336[医药卫生—人体生理学]