119例中老年人股骨小转子处股骨与髓腔直径比值与骨密度关系的研究  

STUDY ON RELATIONSHIP BETWEEN RATIO OF FEMUR TO MEDULLARY CAVITY DIAMETER AND BONE MINERAL DENSITY IN 119 MIDDLE-AGED AND ELDERLY PEOPLE

作　　者：李旻 王娜 王静 马春梅 蒋雨宸 冯林杰 平少华 LI Min;WANG Na;WANG Jing;MA Chunmei;JIANG Yuchen;FENG Linjie;PING Shaohua(Department of Orthopedics,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院骨科,063000 [2]华北理工大学附属医院耳鼻喉科,063000 [3]河北省定州市人民医院 [4]华北理工大学附属医院CT室,063000

出　　处：《中国煤炭工业医学杂志》2021年第3期264-269,共6页Chinese Journal of Coal Industry Medicine

基　　金：2019年度河北省医学科学研究课题(编号:20191152);华北理工大学科学研究基金项目(编号:Z201538)。

摘　　要：目的探讨119例中老年人小转子处股骨与髓腔直径比值与骨密度的相关性,预测骨密度值及判断骨质疏松症的准确性。方法华北理工大学附属医院2014年1月—2020年1月同时行骨盆正位片和骨密度检查的55岁以上中老年人119例。通过骨盆正位X线片,测量得到股骨小转子上缘、中点、下缘股骨直径与髓腔直径的比值。经双能X线骨密度测量仪测量腰椎及股骨颈骨密度。按T值≤-2.5标准差将其分为骨质疏松组40例与非骨质疏松组79例。比较二组性别、年龄、体重指数。通过Pearson偏相关分析,揭示股骨髓腔直径比值与腰椎和股骨颈骨密度之间的相关性。通过一元线性方程分析股骨髓腔直径比值预测骨密度的准确性。通过接受者工作特征曲线(ROC)确定股骨髓腔直径比值诊断骨质疏松症的最佳值及准确率,预测的灵敏度和特异性。结果骨质疏松组平均年龄(68.98±6.68)岁,男11例,占27.5%,女29例,占72.5%、小转子处股骨髓腔直径上缘、中点、下缘比值分别为(1.124±0.063)、(1.199±0.058)、(1.263±0.073);非骨质疏松组平均年龄(65.76±6.27)岁,男40例,占50.6%,女39例,49.4%,小转子处股骨髓腔直径上缘、中点、下缘比值分别为(1.187±0.073)、(1.324±0.086)、(1.385±0.074),二组比较,差异均有统计学意义(均P<0.05)。Pearson偏相关分析小转子处上缘、中点、下缘股骨髓腔直径比值与股骨颈骨密度的相关性结果分别为(r=0.173,P=0.061)、(r=0.310,P=0.001)、(r=0.508,P=0.000),与腰椎骨密度相关性结果分别为(r=0.282,P=0.002)、(r=0.399,P=0.000)、(r=0.507,P=0.000)。股骨颈骨密度和腰椎骨密度与小转子下缘股骨髓腔直径比拟合一元线性回归方程结果分别为(调整后R2=0.267,F=43.967,P=0.000),(调整后R2=0.264,F=43.260,P=0.000),方程均有统计学意义;小转子下缘股骨髓腔直径比值每增加0.01,股骨颈骨密度值增加0.00806g/cm^(2),腰椎骨密度值增加0.00747g/cm^(2)�Objective To explore the correlation between the ratio of femur to medullary cavity diameter and bone mineral density in 119 middle-aged and elderly people, and to predict the bone mineral density and judge the accuracy of osteoporosis.Methods A total of one hundred and nighteen middle-aged and elderly people over 55 years old who underwent pelvic radiography and bone mineral density examination from January 2014 to January 2020 were selected by random number table method.The ratio of femoral diameter to medullary cavity diameter at the upper edge, middle point and lower edge of trochanter was measured by pelvic X-ray.Bone mineral density of lumbar vertebrae and femoral neck was measured by dual-energy X-ray bone mineral density meter.According to t value ≤-2.5,they were divided into osteoporosis group(40 cases) and non-osteoporosis group(79 cases).The gender, age and body mass index of the two groups were compared.Pearson partial correlation analysis revealed the correlation between the ratio of femoral marrow cavity diameter and bone mineral density of lumbar vertebrae and femoral neck.The accuracy of predicting bone mineral density by the ratio of femoral marrow cavity diameter was further clarified by fitting the linear equation with scatter diagram.The receiver operating characteristic curve(ROC) curve was used to determine the optimal value and accuracy of femoral marrow cavity diameter ratio in diagnosing osteoporosis, and the sensitivity and specificity of prediction.Results In the osteoporosis group, the average age was(68.98±6.68) years, and the gender was male 11 cases, 27.5% and female 29 cases 72.5%.The ratio of the upper edge, the middle point and the lower edge of the femoral marrow cavity diameter at the lesser trochanter were(1.124± 0.063),(1.199 ±0.058) and(1.263±0.073) respectively In the non-osteoporosis group, the average age was(65.76 ±6.27) years, and the gender was male 40 cases, 50.6% and female 39 cases, 49.4%.The ratio of the upper edge, the middle point and the lower edge of the

关 键 词：小转子股骨直径与股骨髓腔直径比 骨密度 中老年人 

分 类 号：R693[医药卫生—泌尿科学]