X射线骨皮质厚度值及扫描灰度值对老年骨质疏松症病人髋部脆性骨折风险的预测价值  

Value of cortical bone thickness and gray value measured by X-ray in predicting the risk of hip fragility fracture in elderly patients with osteoporosis

作　　者：徐沁 王黎明[1] 沙卫平[1] 严飞[1] 黄群 周志平[1] XU Qin;WANG Li-ming;SHA Wei-ping;YAN Fei;HUANG Qun;ZHOU Zhi-ping(Department of Orthopedics,Zhangjiagang Hospital Affiliated to Soochow University,Suzhou 215600,China)

机构地区：[1]苏州大学附属张家港医院骨科,江苏省苏州市215600

出　　处：《实用老年医学》2022年第8期805-808,共4页Practical Geriatrics

摘　　要：目的探讨X射线扫描灰度值及骨皮质厚度值对老年骨质疏松症病人髋部脆性骨折风险的预测价值。方法回顾性分析2018年3月至2021年2月在本院行X线骨盆检查的82例老年骨质疏松症病人的临床资料。统计病人髋部脆性骨折的发生情况,并比较骨折组和未骨折组病人的临床资料。采用多因素Logistic回归分析老年骨质疏松症病人发生髋部脆性骨折的危险因素,采用ROC曲线分析X射线扫描灰度值、骨皮质厚度值对老年骨质疏松症病人髋部脆性骨折风险的预测价值。结果入组病人共28例发生髋部脆性骨折,发生率为34.15%。骨折组腰椎L_(2)处骨密度值、髋部大转子骨密度值、小转子上和小转子下的骨皮质厚度值、X射线扫描灰度值均低于未骨折组(P<0.05)。多因素Logistic回归分析结果显示,小转子上骨皮质厚度值(OR=3.374,95%CI:1.853~8.429,P=0.012)及X射线扫描灰度值(OR=3.133,95%CI:1.506~6.475,P=0.023)是老年骨质疏松症病人髋部脆性骨折发生的危险因素。ROC曲线分析显示,小转子上骨皮质厚度值联合X射线扫描灰度值预测老年骨质疏松症病人发生髋部脆性骨折的AUC为0.856,高于二者单独预测的AUC(Z=1.976,P=0.048;Z=2.202,P=0.028)。结论小转子上骨皮质厚度值及X射线扫描灰度值可预测老年骨质疏松症病人髋部脆性骨折的发生风险,且二者联合的预测效能更高。Objective To investigate the value of cortical bone thickness and gray value measured by X-ray in predicting the risk of hip fragility fracture of the elderly patients with osteoporosis.Methods The clinical data of 82 elderly patients with osteoporosis who underwent X-ray pelvic examination in our hospital from March 2018 to February 2021 were retrospectively analyzed.The incidence of hip fragility fracture of the patients was recorded,and the clinical data of the fracture group and the non-fracture group were compared.The risk factors of hip fragility fracture in the elderly patients with osteoporosis were analyzed by Multivariate Logistic regression,and the receiver operating characteristic(ROC)curve was drawn to analyze the value of cortical bone thickness and gray value measured by X-ray in predicting the risk of hip fragility fracture in the elderly patients with osteoporosis.Results Among the 82 patients,28 presented with hip fragility fracture,and the incidence rate was 34.15%.The bone mineral density of L_(2) vertebra and greater trochanter,the cortical bone thickness of the upper and the lower of lesser trochanter,and the gray value of X-ray scanning in the fracture group were lower than those in the non-fracture group(P<0.05).Multivariate Logistic regression analysis showed that the cortical bone thickness of the upper of lesser trochanter(OR=3.374,95%CI:1.853-8.429,P=0.012)and gray value of X-ray scanning(OR=3.133,95%CI:1.506-6.475,P=0.023)were the risk factors for hip fragility fracture in the elderly patients with osteoporosis.ROC curve analysis showed that the area under the curve(AUC)of the cortical bone thickness of the upper of lesser trochanter combined with the gray value of X-ray scanning in predicting hip fragility fracture in the elderly patients with osteoporosis was 0.856,which was higher than that of the two indexes separately(Z=1.976,P=0.048;Z=2.202,P=0.028).Conclusions The cortical bone thickness of the upper of lesser trochanter and the gray value of X-ray scanning can predict the risk

关 键 词：老年人 骨质疏松症 X射线 骨皮质厚度 灰度值 髋部脆性骨折 

分 类 号：R445.4[医药卫生—影像医学与核医学]