定量CT测量北京城乡老年人股骨近段骨密度与骨结构比较  

Comparisons of proximal femoral bone mineral density and hip structure parameters between rural and urban elderly people in Beijing by quantitative computed tomography

作　　者：张天宇[1,2] 程晓光[2] 王玲[2] 张勇[3] ZHANG Tian-yu CHENG Xiao-guang WANG Ling ZHANG Yong(Department of Radiology, Hospital of Qinghe Branch of Beifing Prison Administration, Beijing 300481, China Department of Radiology, Belting Jishuitan Hospital, Belting 100035, China Department of Intervention, Beijing Chaoyang Hospital, Beijing 100020, China)

机构地区：[1]北京市监狱管理局清河分局医院放射科,北京300481 [2]北京积水潭医院放射科,北京100035 [3]北京朝阳医院介入科,北京100020

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2017年第4期342-349,共8页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金(81071131);北京市卫生系统高层次卫生技术人才培养项目(2009-2-03)

摘　　要：目的分析北京城区与农村老年人群的股骨近段骨密度(bone mineral density,BMD)与骨结构参数差异。方法回顾性分析2012年12月1日至2013年12月1日接受髋部定量CT(quantitative computed tomography,QCT)扫描的174名50~70岁的北京居民的相关临床资料,根据居住地分为城区组(n=118)(男性46名、女性72名)和农村组(n=56)(男性31名、女性25名)。统计学分析由QCT测得的股骨颈体积骨密度(femoral neck volumetric bone mineral density,FN v BMD)、全髋体积骨密度(total hip volumetric bone mineral density,TH v BMD)、股骨颈面积骨密度(femoral neck areal bone mineral density,FN a BMD)、股骨大粗隆面积骨密度(trochanter areal bone mineral density,TR a BMD)、股骨粗隆间面积骨密度(intertrochanter areal bone mineral density,IT a BMD)和全髋面积骨密度(total hip areal bone mineral density,TH a BMD)等参数以及股骨近段骨强度(hip strength analysis,HSA)参数,包括股骨颈干角(neck shaft angle,NSA)、颈宽度(femur neck width,FNW)、髋轴长(hip axis length,HAL)、股骨颈横截面惯性矩(cross-sectional moment of inertia,CSMI)、股骨颈横截面面积(cross-sectional area,CSA)、曲率比率(buckling ratio,BR)、平均骨皮质厚度(averaged cortical thickness,ACT)、截面模数(section modulus,SM)等在两组人群中的差异。结果城乡男女身高比较,差异均无统计学差异(P>0.05),城区老年男性体质量(73.66±12.63)kg显著高于农村男性(67.8±9.58)kg(P<0.05);城乡男性之间的FN v BMD、TH v BMD、FN a BMD、TR a BMD、IT a BMD、TH a BMD、NSA、FNW、HAL、CSMI、CSA、BR、ACT、SM各项指标差异均无统计学意义;农村女性HAL显著高于城区女性HAL(109.41 mm vs 104.23 mm),差异有统计学意义(P<0.05);其余骨密度及骨结构参数比较,差异无统计学意义(P>0.05)。结论除老年女性HAL城乡之间存在差异外,本研究人群股骨近段QCT骨密度与骨结构参数无城乡差别。Objective To compare the differences of proximal femoral bone mineral density （BMD） and hip structure parameters between rural and urban elderly people in Beijing. Methods The clinical data of 174 Beijing residents receiving quantitative computed tomography （QCT） of hip from Dec 1 st, 2012 to Dec 1 st, 2013 was retrospectively analyzed. The participants were divided into the urban group （46 men and 72 women, 50-70 years） and the rural group （31 men and 25 women, 50-70 years） according to the residence. The differences of femoral neck volumetric bone mineral density （FN vBMD）, total hip volumetric bone mineral density （TH vBMD）, femoral neck areal bone mineral density （FN aBMD）, trochanter areal bone mineral density （TR aBMD） , intertrochanter areal bone mineral density （IT aBMD）, total hip areal bone mineral density （ TH aBMD ） and parameters of hip strength analysis （ HSA ） including neck shaft angle （NSA） , femur neck width （ FNW）, hip axis length （ HAL）, cross-sectional moment of inertia （ CSMI）, cross-sectional area （CSA）, buckling ratio （BR）, averaged cortical thickness （ACT） and section modulus （SM） measured by QCT software between the two groups were statistically analyzed. Results There was no difference on height between rural and urban subjects in both sexes groups, whereas urban elderly males （73.66±12. 63 kg） were heavier than rural males （67. 82±9. 58 kg） （P〈0. 05）. No significant differences were found between rural and urban men in all parameters. Interestingly, HAL of rural women was significantly higher than that of urban subjects （median, 109.41 millimeter vs 104. 23 millimeter ） （P〈0. 05）, whereas no significant differences were found between rural and urban women in the other parameters. Conclusion HAL of rural elderly women was significantly higher than that of urban women, whereas no significant differences were found in the other QCT BMD and HSA parameters between rural and urban elderly pe

关 键 词：定量CT 北京城乡 股骨近段 骨密度 骨结构 

分 类 号：R681[医药卫生—骨科学]