应用定量CT探讨绝经后女性股骨近端骨折的危险因素  

Evaluation of the risk factors of proximal femoral fractures in postmenopausal women using quantitativecomputed tomography

作　　者：仲玉侨 王植[1] 孟祥虹[1] 祝凤玲 徐华[1] 樊红星 ZHONG Yu-qiao;WANG Zhi;MENG Xiang-hong(Department of Radio-logy,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医院放射科,天津300211 [2]天津医科大学医学技术学院,天津300203

出　　处：《放射学实践》2022年第12期1568-1572,共5页Radiologic Practice

基　　金：资助医疗卫生专家学者科技创新小微项目课题基金(20002)。

摘　　要：目的:应用定量CT(QCT)探讨绝经后女性股骨近端骨折的危险因素。方法:连续纳入2021年1月-2021年12月在我院行髋关节CT检查的绝经后女性患者522例,分为骨折组(232例)及无骨折组(290例)。骨折组年龄52~99岁,平均(72.7±9.8)岁;无骨折组年龄51~87岁,平均(66.3±9.6)岁。采用QCT分析软件测量股骨近端骨密度及臀大肌的脂肪含量。采用t检验比较两组中年龄、体质指数、骨密度和肌肉脂肪含量的差异。绘制ROC曲线确定年龄、骨密度和肌肉脂肪含量预测骨折的阈值。应用Pearson相关分析评估两组中年龄、骨密度与肌肉脂肪含量的相关性。结果:骨折组患者年龄的均值较无骨折组大6.4岁,组间差异有统计学意义(t=7.43,P<0.001)。骨折组股骨近端骨密度为(93.0±33.3)mg/cm^(3),无骨折组为(113.5±36.1)mg/cm^(3),骨折组股骨近端骨密度更低(t=-6.70,P<0.001)。骨折组髋部臀大肌的脂肪含量为12.9%±6.9%,无骨折组为11.1%±5.2%,骨折组肌肉脂肪含量更高(t=3.43,P<0.001)。骨折组和无骨折组的体质指数分别为(23.38±3.9)和(24.46±3.7)kg/m^(2),两组间差异无统计学意义(t=-3.45,P>0.05)。年龄在73.5岁以上、骨密度低于112.3mg/cm^(3)和肌肉脂肪含量达12.8%以上时,更容易发生骨折(P<0.05)。股骨近端骨密度与其邻近肌肉的脂肪含量呈负相关(骨折组:r=-0.403,无骨折组,r=-0.191)。结论:QCT可定量测量股骨近端骨密度和其周围肌肉的脂肪含量,有助于预测绝经后女性发生股骨近端骨折的风险,指导临床对骨折高危人群进行监测和早期预防。Objective:To explore the risk factors of proximal femoral fracture in postmenopausal women by use of quantitative computed tomography(QCT).Methods:A total of 522 postmenopausal women who underwent hip CT examination in our hospital from January 2021 to December 2021 were continuously recruited in this study and then divided into two groups:fracture group(n=232)and non-fracture group(n=290).The patients aged 52~99 years with mean of(72.7±9.8)y in fracture group,and 51~87y with mean of(66.3±9.6)y.Bone mineral density(BMD)of proximal femur and fat content(FC)of the gluteus maximus were measured by QCT analysis software.T-test was used to compare the difference of age,body mass index(BMI),bone mineral density and muscle fat content between the two groups.ROC curve was drawn to determine the threshold value of age,bone mineral density and muscle fat content to predict fracture.Pearson correlation analysis was used to analyze the correlation between age,BMD and muscle FC in the two groups.Results:The patients in fracture group was older(t=7.43,P<0.001)with an average of 6.4 years older than that of the non-fracture group.The BMD of proximal femur was(93.0±33.3)mg/cm^(3) in fracture group and(113.5±36.1)mg/cm^(3) in non-fracture group,and the BMD of proximal femur in fracture group was lower than that in non-fracture group with statistically difference(t=-6.70,P<0.001).The FC of gluteus maximus in fracture group was 12.9%±6.9%,and that in non-fracture group was 11.1%±5.2%.The muscle FC in fracture group was higher than that in non-fracture group with statistically difference(t=3.43,P<0.001).The body mass index(BMI)was(23.38±3.9)kg/m^(2) in the fracture group and(24.46±3.7)kg/m^(2) in the non-fracture group;there was no significant difference between the two groups(t=-3.45,P>0.05).The proximal femur fracture was easy to occur(P<0.05)when the age was above 73.5 years old,the bone density was lower than 112.3mg/cm^(3),and the muscle FC was above 12.8%.BMD of proximal femur was negatively correlated with muscle FC(f

关 键 词：体层摄影术 X线计算机 绝经后女性 骨质疏松 骨密度 肌肉脂肪含量 

分 类 号：R814.42[医药卫生—影像医学与核医学] R683.42[医药卫生—放射医学]