成人非创伤性股骨头坏死骨密度定量分析  

Quantitative analysis of bone density of adults with non-traumatic femur head necrosis

作　　者：冯强强[1] 王玲[1] 程晓光[1] 郭晓忠[1] FENG Qiangqiang;WANG Ling;CHENG Xiaoguang;GUO Xiaozhong(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院,北京100035

出　　处：《中医正骨》2018年第10期25-29,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨成人非创伤性股骨头坏死患者骨密度的特征。方法:收集2015年6月至2017年6月在北京积水潭医院行CT检查诊断为非创伤性股骨头坏死的患者(坏死组)。共31例48髋,男36髋、女12髋,年龄(47. 42±15. 29)岁,ARCO分期Ⅱ期21髋、Ⅲ期27髋。均无骨盆或髋关节外伤及手术史,未进行过药物干预。同时选取2015年6月至2017年6月因单侧髋关节骨折在北京积水潭医院行髋关节CT检查的患者(非坏死组)。共52例52髋,男38髋、女14髋,年龄(47. 42±15. 29)岁,对侧股骨均无异常。采用非同步定量CT测定坏死组股骨头坏死区、坏死周围区域、股骨颈、大转子、转子间的骨密度,测定非坏死组非骨折侧股骨头中心、股骨头边缘、股骨颈、大转子、转子间的骨密度,并对测得的数据做统计分析。结果:坏死组坏死区骨密度大于非坏死组股骨头中心骨密度[(348. 44±78. 77) mg·cm^(-3),(284. 05±45. 88) mg·cm^(-3),t=4. 942,P=0. 000];坏死组坏死周围区域骨密度大于非坏死组股骨头边缘骨密度[(218. 59±47. 82) mg·cm^(-3),(141. 37±31. 93) mg·cm^(-3),t=9. 419,P=0. 000]; 2组股骨颈、大转子、转子间骨密度比较,组间差异均无统计学意义[(98. 63±58. 43) mg·cm^(-3),(81. 14±63. 78) mg·cm^(-3),t=1. 426,P=0. 157;(45. 38±37. 15) mg·cm^(-3),(52. 55±31. 23) mg·cm^(-3),t=-1. 048,P=0. 297;(48. 14±34. 07) mg·cm^(-3),(45. 37±42. 60) mg·cm^(-3),t=0. 357,P=0. 722]。坏死组ARCOⅡ期坏死周围区域骨密度大于非坏死组股骨头边缘骨密度[(228. 97±49. 64) mg·cm^(-3),(141. 37±31. 93) mg·cm^(-3),t=7. 486,P=0. 000];坏死组ARCOⅡ期坏死区、股骨颈、大转子、转子间骨密度与非坏死组比较,组间差异均无统计学意义[(307. 31±64. 15) mg·cm^(-3),(284. 05±45. 88) mg·cm^(-3),t=1. 513,P=0. 141;(100. 71±45. 88) mg·cm^(-3),(81. 14±63. 78) mg·cm^(-3),t=1. 277,P=0. 206;(65. 39±26. 72) mg·cm^(-3),(52. 55±31. 23) mg·cm^(-3),t=1. 653,P=0. 103;(59. 97±31. 76) mObjective:To explore the characteristics of bone density of adults with non-traumatic femur head necrosis(FHN).Methods:Thirty-one patients who were diagnosed as non-traumatic FHN(necrotic group)by computerized tomography(CT)examination in Beijing Jishuitan Hospital from June 2015 to June 2017 were collected.The patients(48 hips)consisted of males(36 hips)and females(12 hips),and ranged in age of 47.42+/-15.29 years,and the FHN belonged to ARCO phaseⅡ(21 hips)and ARCO phaseⅢ(27 hips).None of these patients had a history of trauma and surgery of pelvis or hip and received any drug intervention.Meanwhile,fifty-two patients who received hip CT examination for unilateral hip fracture(non-necrotic group)in Beijing Jishuitan Hospital from June 2015 to June 2017 were selected.The patients(52 hips)consisted of males(38 hips)and females(14 hips),and ranged in age of 47.42+/-15.29 years,and no abnormality was found in contralateral femur.The bone density of FHN area,FHN surrounding area,femoral neck,greater trochanter and intertrochanteric area of necrotic group and the bone density of center of femoral head,edge of femoral head,femoral neck,greater trochanter and intertrochanteric area of non-fractured side of non-necrotic group were determined by using non-synchronous quantitative CT,and then the measured data were statistically analyzed.Results:The bone density of FHN area of necrotic group was higher than that of center of femoral head of non-necrotic group(348.44+/-78.77 vs 284.05+/-45.88 mg/cm(-3),t=4.942,P=0.000).The bone density of FHN surrounding area of necrotic group was higher than that of edge of femoral head of non-necrotic group(218.59+/-47.82 vs 141.37+/-31.93 mg/cm(-3),t=9.419,P=0.000).There was no statistical difference in the bone density of femoral neck,greater trochanter and intertrochanteric area between the 2 groups(98.63+/-58.43 vs 81.14+/-63.78 mg/cm(-3),t=1.426,P=0.157;45.38+/-37.15 vs 52.55+/-31.23 mg/cm(-3),t=-1.048,P=0.297;48.14+/-34.07 vs 45.37+/-42.60 mg/cm(-3),t=0.357,P=0.722).The bone de

关 键 词：股骨头坏死 骨密度 定量CT 

分 类 号：R681.8[医药卫生—骨科学]