正视不同厂家DXA腰椎和股骨近端骨密度测量结果的差异Hologic和GE-Lunar DXA在全国流调人群测量数据分析  

Recognition the differences of bone mineral density measurements at lumbar spine and proximal femur with different DXA:analysis of the results by both of Hologic DXA and GE-Lunar DXA in population from epidemiological survey

作　　者：余卫[1] 崔丽嘉 尹香君 汤淑女 江宁 崔露 李志新 王临虹[3] 管文敏[1] 夏维波[2] YU Wei;CUI Li-jia;YIN Xiang-jun;TANG Shu-nv;JIANG Ning;CUI Lu;LI Zhi-xin;WANG Lin-hong;GUAN Wen-min;XIA Wei-bo(Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院内分泌科,北京100730 [3]中国疾病控制中心慢性非传染性疾病预防控制中心,北京100050

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2021年第2期126-133,共8页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的依据Hologic和GE-Lunar两厂家双能X线吸收测量仪(dual-energy X-ray absorptiometry,DXA)在流行病学调查(简称流调)人群腰椎和股骨近端测量数据的差异,探讨其对骨质疏松症的诊断、骨质疏松性骨折风险评估和治疗随访评估的影响。方法纳入全国流调20285例受检者,行Hologic公司DXA腰椎骨密度测量且合格者共9450例,其中男性3989例,女性5461例;股骨近端测量且合格者共9463,其中男性4008例,女性5455例;行GE-Lunar公司DXA腰椎骨密度测量且合格者共10319例;其中男性4550例,女性5769例;股骨近端测量且合格者共10602例,其中男性4667例,女性5935例。另收集不同参研单位Hologic DXA与不同参研单位GE-Lunar DXA对同一欧洲脊椎体模的骨密度测量结果。结果Hologic公司DXA和GE-Lunar公司DXA两组男、女骨密度峰值后,随年龄的增高其不同年龄组腰椎、股骨颈和全髋的骨密度测量均值逐渐下降趋势相似;Hologic公司DXA和GE-Lunar公司DXA两组男、女峰值骨所在的年龄组及随后的不同年龄组腰椎、股骨颈和全髋的骨密度测量值有所不同;Hologic DXA和GE-Lunar DXA两组欧洲脊椎体模测量骨密度有显著性差异(P<0.001)。结论临床实际工作中,应正视Hologic和GE-Lunar两厂家DXA腰椎和股骨近端骨密度测量结果的差异以及其对骨质疏松症诊断和其骨折风险评估的影响,重视结合对患者或受检者其他骨质疏松症和其骨折风险因素的分析,进而对其进行个体化的综合性评估。Objective Based on the analysis of different results at lumbar spine and proximal femur by both Hologic DXA and GE-Lunar dual-energy X-ray absorptiometry(DXA)in population from epidemiological survey,the effects on diagnosis,fracture risk assessment as well as follow-up assessment for osteoporosis were discussed in the study.Methods Of the20285 subjects from epidemiological survey,bone mineral density(BMD)was eligibly measured by Hologic DXA at lumbar spine in 9450 cases(male:3989;female:5461),and at proximal femur in 9463 cases(male:4008;female:5455),as well as by GE-Lunar DXA at lumbar spine in 10319 cases(male:4550;female:5769),and at proximal femur in 10602 cases(male:4667;female:5935).The BMD measurements by Hologic DXA and GE-Lunar DXA for the same European spine phantom were also collected from each research sites.Results After peak bone density measurements,aging decrease tendency of the average BMD at the sites of lumbar vertebrae,femur neck,and total hip in each different male and female age groups was similar for both Hologic DXA and GE-Lunar DXA.Also,differences of peak bone density,average BMD at the sites of lumbar spine,femur neck,and total hip in each different male and female age groups were observed for Hologic DXA and GE-Lunar DXA.There was significant BMD difference between Hologic DXA and GE-Lunar DXA for the measurements of European spine phantom(P<0.001).Conclusions The differences of BMD measurements between Hologic DXA and GE-Lunar DXA at sites of lumbar spine and proximal femur,as well as the effects on diagnosis,fracture risk assessment,and follow-up assessment for osteoporosis should be recognized in clinical practice.Attention is paid to further analysis of other osteoporotic and/or fracture risk factors in patients or subjects,which in turn provides a comprehensive and individualized evaluation.

关 键 词：双能X线吸收测量仪 骨密度 流行病学 腰椎 股骨近端 

分 类 号：R617[医药卫生—外科学] R681[医药卫生—临床医学]