跟骨定量超声测量筛查体检绝经期妇女骨质疏松症的临床价值分析  

Clinical significance of quantitative ultrasound measurement of calcaneus in screening osteoporosis in postmenopausal women in community

作　　者：马爱玲[1] 朱丽[1] 赵小辉[1] 杜晓丽[1] MA Ai-ling;ZHU Li;ZHAO Xiao-hui(Department of Gynecology,Cangzhou Hospital of Integrated Chinese and Western Medicine,Cangzhou Hebei 061000,China.)

机构地区：[1]河北省沧州中西医结合医院妇科

出　　处：《临床和实验医学杂志》2019年第11期1224-1227,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省重点科技研究计划项目(编号:20171352)

摘　　要：目的分析并评价跟骨定量超声测量(QUS)筛查体检绝经期妇女骨质疏松症的临床价值。方法采用采用前瞻性随机单盲对照研究法,选择2017年1月至2018年6月沧州中西医结合医院体检中心收入的450例健康体检的绝经期妇女作为研究对象,分别给予双能X线吸收仪(DXA)检测和QUS检测,以DXA检测结果为金标准,评价QUS筛查绝经期妇女骨质疏松症的临床价值,同时观察不同年龄段(≤59岁226例、60~69岁142例、≥70岁82例)妇女的骨密度变化情况。结果DXA诊断骨质疏松症共81例,QUS诊断骨质疏松症共69例,以DXA检测结果为金标准,QUS诊断正确67例,其诊断正确率为97.1%(67/69)。同时,QUS诊断骨质疏松症的特异度、灵敏度、阳性预测值、阴性预测值分别为99.5%、82.7%、97.1%、96.3%;≤59岁组、60~69岁组、≥70岁组的刚度(SI)、超声振幅衰减(BUA)、超声传导速度(SOS)参数比较差异均具有统计学意义(P<0.05);≤59岁组、60~69岁组、≥70岁组患骨质疏松症的比率分别为9.3%、15.5%、31.7%,差异具有统计学意义(Z=21.365,P<0.01)。结论QUS筛查绝经期妇女骨质疏松症的诊断正确率较高,诊断特异度及灵敏度均较好,具有较高的临床应用价值;随着年龄的增加,绝经期妇女患骨质疏松症的概率也会随之增大。Objective To analyze and evaluate the clinical value of quantitative calcaneal ultrasound(QUS)in screening osteoporosis in postmenopausal women in community.Methods A prospective randomized,single-blind,controlled study was conducted to select 450 healthy menopausal women from the Physical Examination Center of Zhangzhou Chinese Traditional Medicine combined Western Medicine Hospital during January 2017 to June 2018 as subjects.(DXA)detection and QUS testing,by using results of DXA test as the gold standard,evaluating the clinical value of QUS screening for osteoporosis in menopausal women,and observing different age groups(226 cases of≤59 years old,142 cases of60~69 years old,≥70 years old 82 cases)changes in bone mineral density in women.Results DXA diagnosed 81 cases of osteoporosis,and QUS diagnosed osteoporosis in 69 cases.The DXA test results were the gold standard,and QUS diagnosis was correct in 67 cases.The diagnostic accuracy was 97.1%(67/69).At the same time,the specificity,sensitivity,positive predictive value and negative predictive value of QUS diagnosis of osteoporosis were 99.5%,82.7%,97.1%and 96.3%in≤59 years old,60~69 years old and≥70 years old groups The difference in stiffness(SI),ultrasonic amplitude attenuation(BUA),and ultrasound conduction velocity(SOS)parameters were statistically significant(P<0.05).The percentages of quality loosening in≤59 years old,60~69 years old and≥70 years old group suffered bone loosening were 9.3%,15.5%,and 31.7%,respectively,and the difference was statistically significant(Z=21.365,P<0.01).Conclusion QUS screening for menopausal women with osteoporosis has a high diagnostic accuracy rate,good diagnostic specificity and sensitivity,and it has a high clinical value;with the increase of age,the probability of osteoporosis in menopausal women is increased.

关 键 词：绝经期妇女 骨质疏松症 跟骨定量超声测量 临床价值 

分 类 号：R580[医药卫生—内分泌] R445.1[医药卫生—内科学]