髋部骨折患者的股骨头松质骨骨密度的定量CT研究  

QCT Study on Cancellous BMD of Femoral Head in Cases with Hip Fracture

作　　者：李现龙 许乐洋[1] 范永前[1] Li Xianlong;Xu Yueyang;Fan Yongqian(Department of Orthopaedics,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院骨科

出　　处：《老年医学与保健》2019年第5期578-582,589,共6页Geriatrics & Health Care

基　　金：上海市科学技术委员会科研计划项目(15411951500);上海市卫生计生系统重要薄弱学科-老年医学(2015ZB0501)

摘　　要：目的利用定量CT(QCT)中“3D Spine Exam Analysis”软件分析模块测量股骨头不同层面的松质骨骨密度,研究髋部骨折与非髋部骨折患者的股骨头骨密度是否存在差异。方法回顾性研究344例受试者股骨头松质骨的骨密度,其中股骨颈骨折(femoral neck fracture,NF)患者119例,股骨粗隆间骨折(intertrochanteric fracture,ITF)患者92例,非髋部骨折(non-hip fracture,NHF)患者133例。将QCT数据文件传输至QCT工作站,利用“3D Spine Exam Analysis”软件分析模块将股骨头划分为上、中、下3个层面:靠近股骨颈上部皮质、经股骨颈中心、靠近股骨颈下部皮质。由1名熟练的操作者对受试者股骨头进行测量,计算并记录平均值。结果3组受试者的年龄不完全相同,且两两比较差异均有统计学意义(χ^2=92.287,P=0.000,P NF&ITF=0.020,P NF&NHF=0.000,P ITF&NHF=0.000);3组受试者的性别构成差异无统计学意义(χ^2=0.157,P=0.925);髋部骨折与非髋部骨折组股骨头骨密度差异有统计学意义,其中NF与ITF的股骨头骨密度之间差异无统计学意义(上层:F=53.654,P=0.000,PNF&ITF=1.000,P NF&NHF=0.000,P ITF&NHF=0.000;中层:χ^2=83.229,P=0.000,P NF&ITF=0.342,P NF&NHF=0.000,P ITF&NHF=0.000;下层:χ^2=73.749,P=0.000,PNF&ITF=0.956,P NF&NHF=0.000,P ITF&NHF=0.000)。结论本次研究中,NF、ITF及NHF组之间无性别构成差异。3组年龄构成有统计学差异,且ITF组整体年龄最大。髋部骨折与NHF组之间股骨头骨密度值存在统计学差异。Objective To explore the possible differences in bone mineral density(BMD)of femoral head between cases with hip fracture and non-hip fracture through measuring the cancellous BMD at different layers by"3D Spine Exam Analysis module of quantitative CT(QCT).Methods A retrospective analysis was made to the cancellous BMDof 344 cases,including 119 cases with femoral neck fracture(NF group),92 cases with intertrochanteric fracture(ITF group)and 133 cases with non-hip fracture(NHF group);the QCT data was transferred to the QCT analysis workstation and the"3D Spine Exam Analysis"module of QCT Pro software was applied in cutting the femoral head into 3 layers:the upper layer(cortex close to femoral neck),the middle layer(cortex through the center of femoral neck)and the lower layer(cortex close to the lower end of femur);an experience operator took up the measurement of femoral neck,the calculation and recording of the average values.Results The comparison of ages between every 2 groups in three groups was of statistical significance(χ^2=92.287,P=0.000,PNF&ITF=0.020,PNF&NHF=0.000,PITF&NHF=0.000);the difference in gender among the 3 groups was of no statistical significance(χ^2=0.157,P=0.925);there existed a statistical difference in BMD of femoral head between the cases with hip fracture and non-hip fracture while no statistical difference between the cases with femoral neck fracture and intertrochanteric fracture(upper layer:F=53.654,P=0.000,PNF&ITF=1.000,PNF&NHF=0.000,PITF&NHF=0.000;middle layer:χ^2=83.229,P=0.000,PNF&ITF=0.342,PNF&NHF=0.000,PITF&NHF=0.000;lower layer:χ^2=73.749,P=0.000,PNF&ITF=0.956,P NF&NHF=0.000,PITF&NHF=0.000).Conclusions There exists no difference in gender among the case groups with femoral neck fracture,intertrochanteric fracture and non-hip fracture;the cases in the 3 groups are at difference ages and the cases with intertrochanteric fracture are the oldest;the BMD of femoral neck is of statistical difference between the cases with hip fracture and non-hip fracture.

关 键 词：骨密度 定量CT 股骨头 髋部骨折 

分 类 号：R68[医药卫生—骨科学]