骨质疏松患者下颌骨随访的初步研究  

Preliminary study of bone mineral density at the mandible in patients with osteoporosis

作　　者：孙蕴[1] 马兆坤[2] 潘克梫[1] 贺丽英[1] 

机构地区：[1]清华大学医院放射科,北京100084 [2]清华大学医院骨科,北京100084

出　　处：《中国骨质疏松杂志》2017年第2期172-176,共5页Chinese Journal of Osteoporosis

基　　金：清华大学医院科学研究基金(110200004)

摘　　要：目的初步研究下颌体、下颌支做为骨密度随访指标的临床意义。方法采用美国Norland XR-800双能X线骨密度仪,通过重复四次测定30例正常志愿者下颌骨骨密度,计算下颌体、下颌支重复性试验精确度变异系数百分比;通过测定30例正常志愿者及45例骨质疏松或骨量减少患者左股骨近端、正位腰椎、下颌骨骨密度,观察其骨密度的差异;通过测定20例用药患者6个月内左股骨近端、正位腰椎、下颌骨骨密度,随访观察股骨颈、Ward区、L2-4、下颌体、下颌支骨密度(BMD)随时间的变化规律及临床特点。结果 130例正常志愿者下颌体的重复性为2.08%,下颌支的重复性为2.75%,略高于Ward区的重复性变异系数2.27%。245例骨质疏松或骨量减少患者下颌体、下颌支BMD显著降低,与正常志愿者相比,差异有统计学意义(P<0.05)。320例随访用药患者下颌骨BMD变化先于其它部位出现,下颌支BMD四周即可发生变化,早于下颌体。结论下颌骨骨密度变化敏感性高,非常适合做为骨质疏松患者的临床随访指标,优于其他部位的骨密度测量。Objective To study the clinical significance of following up bone mineral density（BMD） of the mandibular body and mandibular ramus.Methods The coefficient of variation was calculated as a measure of repeatability in the assessments of mandibular body and ramus bone mineral density in 30 normal volunteers measured four times by dual-energy X-ray absorptiometry（DXA,Norland XR-600）.The study also compared the differences in BMD of left femur,AP spine and mandible in 30 healthy volunteers and 45 subjects identified with osteoporosis.Finally,the study examined BMD at the femoral neck,Ward s region,AP spine（L2-4）,mandibular body and mandibular ramus during 6 months of follow-up in 20 subjects with osteoporosis.Results First,the precision for BMD in the mandibular body and mandibular ramus was found to be 2.08%and 2.75%,respectively,greater than that for the Ward’ s region（2.27%）.Secondly,BMD of the mandibular body and mandibular ramus was significantly（P 〈 0.05） decreased in the 45 subjects with osteoporosis when compared with the 30 healthy volunteers.Finally,in the 20 patients,the changes in BMD occurred earlier at mandibular body and mandibular ramus than femur and lumbar spine.BMD changes at the mandibular ramus were observed after 4 weeks,earlier than the mandibular body.Conclusions Mandibular body and mandibular ramus BMD were better reflectors of change in BMD in patients with osteoporosis than the assessments of femur and lumbar spine BMD.

关 键 词：骨密度 下颌骨 下颌体 下颌支 骨质疏松 

分 类 号：R68[医药卫生—骨科学]