我国中老年脆性髋部骨折及桡骨远端骨折骨质疏松诊断标准与WHO诊断标准的比较分析  

Comparison of osteoporosis diagnostic criteria of China and WHO in Chinese patients with brittle hip fracture or distal radius fracture

作　　者：郑博 蒋涛[1] 黄佳涌 张秀莉 屈晓龙 ZHENG Bo;JIANG Tao;HUANG Jiayong;ZHANG Xiuli;QU Xiaolong(The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院,四川成都610500

出　　处：《中国骨质疏松杂志》2018年第10期1299-1304,共6页Chinese Journal of Osteoporosis

基　　金：四川省教育厅基金项目(15AZ0265)

摘　　要：目的评估我国中老年髋部骨折及桡骨远端骨折骨质疏松诊断标准与世界卫生组织(World Health Organization,WHO)诊断标准的不同所产生的骨质疏松人群的数量差异,更加精确地指导临床对适宜骨质疏松人群的筛查及治疗。方法收集2016年8月至2018年2月我院骨科年龄在60～80岁的脆性髋部骨折女性患者110例及桡骨远端骨折女性患者100例及与年龄相仿的正常人女性312名,使用双能X线骨密度仪测量腰1～4、股骨颈、股骨大粗隆骨密度,分别计算骨质疏松率;再按照我国骨质疏松诊断标准及WHO诊断标准进行比较分析。结果脆性髋部骨折女性患者腰1～4、股骨颈、股骨大粗隆骨密度低于对照组,差异具有统计学意义(P<0.05);骨质疏松率高于对照组,差异具有统计学意义(P<0.05)。脆性桡骨远端骨折女性患者腰1～4、股骨颈骨密度低于对照组,差异具有统计学意义(P<0.05);骨质疏松率高于对照组,差异具有统计学意义(P<0.05)。股骨大粗隆骨密度低于对照组,骨质疏松率高于对照组,但差异不具有统计学意义(P>0.05)。按照我国骨质疏松诊断标准与WHO诊断标准进行比较,我国脆性髋部骨折及桡骨远端骨折骨质疏松人数多于WHO骨质疏松人数,差异具有统计学意义(P<0.05)。结论据本文分析,我国脆性髋部骨折及桡骨远端骨折骨质疏松率明显高于正常人,我国骨质疏松诊断标准扩大了骨质疏松人数。呼吁更多研究评估我国骨质疏松骨折,特别是脆性桡骨远端骨折的诊断及治疗,适时调整我国骨质疏松诊断标准。Objective To assess the differences in diagnosis between osteoporosis diagnostic criteria of China and WHO in Chinese patients with brittle hip fracture or distal radius fracture,in order to provide more precise guidance for clinical screening and treatment of osteoporosis.Methods From August 2016 to February 2018,110 cases of female brittle hip fracture patients and 100 cases of female distal radius fracture patients of our department(age range 60-80 years)and 312 cases of healthy females of similar age were examined.Dual-energy X-ray absorptiometry was used to measure bone mineral density(BMD)of L1-4,femoral neck and femoral trochanter.Osteoporosis rate was calculated according to the osteoporosis diagnostic criteria of China and WHO.Results Compared with the control group,women with brittle hip fracture had lower BMD at spine L1-4,femoral neck and femoral trochanter,with statistical significance(P<0.05),and higher osteoporosis rate,with statistical significance(P<0.05).Compared with the control group,women with brittle fracture of the distal radius had lower BMD at spine L1-4 and femoral neck,with statistical significance(P<0.05),and higher osteoporosis rate,with statistical significance(P<0.05).Femoral trochanter BMD of women with distal radius brittle fracture was lower than that of the control group,and the osteoporosis rate was higher than that of the control group,but did not reach significance level(P>0.05).According to the osteoporosis diagnosis standard of China,more patients with brittle hip fracture and distal radius fracture were diagnosed osteoporosis compared with using the WHO diagnostic criteria,with statistical significance(P<0.05).Conclusion According to the analysis of this paper,the incidence of brittle hip fracture and distal radius fracture of our country was significantly higher than that of normal population.The osteoporosis diagnostic criteria of China increased the number of osteoporosis diagnosis.More studies to evaluate the diagnosis and treatment of osteoporotic fractures in China,e

关 键 词：髋部骨折 桡骨远端骨折 骨质疏松 诊断标准 老年人 

分 类 号：R683[医药卫生—骨科学]