绝经后女性髋部骨折患者骨骼肌肌纤维特点与骨密度的相关性  

Correlation between skeletal muscle fiber characteristics and bone mineral density in postmenopausal women with hip fractures

作　　者：蔺海山 米尔阿里木•木尔提扎 李鹏[1] 马超[1] 王利[1] Lin Haishan;Mieralimu Muertizha;Li Peng;Ma Chao;Wang Li(Geriatric Ward of Orthopedics,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区人民医院骨科中心关节老年病区,新疆维吾尔自治区乌鲁木齐市830001

出　　处：《中国组织工程研究》2021年第20期3144-3149,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金-面上项目(2017D01C127),项目负责人:王利。

摘　　要：背景:研究认为,肌纤维直径减小和数目减少与肌肉萎缩相关,尤其与Ⅱ型肌纤维关系最为密切。目的:分析绝经后髋部骨折女性患者骨骼肌肌纤维分布特点与骨密度的相关性。方法:纳入因髋部骨折行手术治疗的绝经后女性患者60例的临床资料,通过双能X射线(DXA)检查测量患者骨密度和肌肉含量,并计算四肢骨骼肌指数(ASMI)。根据骨质疏松诊断标准,将患者分为骨量正常、骨量减少、骨质疏松、严重骨质疏松组,每组15例。术中取患者臀中肌肌纤维,染色后镜下观察肌纤维直径及分布特点;检查肌肉含量及健侧股骨颈骨密度;采用Pearson相关分析患者肌纤维直径、骨骼肌含量等指标与健侧股骨颈骨密度的相关性。研究方案已获得新疆维吾尔自治区人民医院伦理委员会的批准,患者对试验过程完全知情同意。结果与结论:①严重骨质疏松组全身肌肉含量与躯干肌肉含量显著低于其余3组(P<0.05),但其余3组两两比较差异无显著性意义(P>0.05);骨量正常组四肢肌肉含量显著高于骨质疏松组、严重骨质疏松组(P<0.05),骨量减少组四肢肌肉含量高于严重骨质疏松组(P<0.05);②严重骨质疏松组四肢骨骼肌指数显著低于骨量正常组、骨量减少组(P<0.05);③绝经后女性髋部骨折患者股骨颈骨密度与年龄、体质量、Ⅱ型肌纤维直径具有一定的相关性;股骨颈骨密度与Ⅱ型肌纤维直径、四肢肌肉含量线性拟合R2分别为0.103,0.243;④结果表明,髋部骨折女性患者骨密度与年龄、体质量指数、肌肉含量不同部位(全身、四肢、躯干)、四肢骨骼肌指数ASMI具有密切相关性;Ⅱ型肌纤维直径大小、四肢肌肉含量与股骨颈骨密度具有正相关性,提示在绝经后老年女性髋部骨折的预防中应同时采用运动锻炼、加强营养、药物治疗的综合方案,提高骨量的同时改善肌肉质量。BACKGROUND:Studies have shown that reduced diameter and number of muscle fibers are related to muscle atrophy,especially type II muscle fibers.OBJECTIVE:To explore the correlation between the distribution characteristics of skeletal muscle fibers and bone mineral density in postmenopausal women with hip fractures.METHODS:The clinical data of 60 female postmenopausal patients undergoing surgical treatment for hip fractures were included.Bone mineral density and muscle content were measured by dual energy X-ray,and the Appendicular Skeletal Muscle Mass Index(ASMI)was calculated.According to the diagnostic criteria for osteoporosis,the included patients were divided into four groups with normal bone mass,reduced bone mass,osteoporosis,and severe osteoporosis,with 15 cases in each group.During operation,the patient’s gluteus medius muscle fibers were taken,and their diameter and distribution characteristics were observed under a microscope after slicing,fixing,and staining.Muscle content and femoral neck bone density at the healthy side were tested.Pearson correlation analysis was used to analyze the correlation between muscle fiber diameter and skeletal muscle content at the affected side and the bone mineral density of the contralateral femoral neck.RESULTS AND CONCLUSION:The body muscle content and trunk muscle content of the severe osteoporosis group were significantly lower than those of the other three groups(P<0.05),but there was no significant difference between the other three groups(P>0.05).The muscle content of the limbs in the normal bone mass group was significantly higher than that in the osteoporosis group and severe osteoporosis group(P<0.05),and the muscle content of the limbs in the reduced bone mass group was higher than that in the severe osteoporosis group(P<0.05).The ASMI value of the limbs in the severe osteoporosis group was significantly lower than that in the normal bone mass group and reduced bone mass group(P<0.05).The femoral neck bone mineral density of postmenopausal women with hip fr

关 键 词：骨 骨折 绝经后 骨质疏松 骨密度 肌纤维 肌肉减少症 体质指数 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学]