双能X线骨密度扫描诊断早期偏侧性帕金森病的临床价值  

Clinical value of dual energy X-ray absorptiometry in the diagnosis of early hemiparkinsonism

作　　者：董家科 邓敏 王禄马[1] 杨涛[2] 迪力夏提·艾热提 阿娜努尔·麦麦提亚森 Dong Jiake;Deng Min;Wang Luma;Yang Tao;Dilixiati Aireti;Ananuer Maimaitiyasen(The First People’s Hospital of Kashi Prefecture,Xinjiang Kashi 844000,China;Department of Imaging,Zhoupu Hospital,Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201318,China;Image Center,Shache County People’s Hospital of Kashi Prefecture,Xinjiang Shache 844799,China)

机构地区：[1]新疆喀什地区第一人民医院影像中心,新疆喀什844000 [2]上海健康医学院附属周浦医院影像科,上海201318 [3]新疆喀什地区莎车县人民医院影像中心,新疆莎车844799

出　　处：《中国医刊》2023年第3期324-327,共4页Chinese Journal of Medicine

基　　金：上海市浦东新区卫健委计划科研项目(PW2019A-26)。

摘　　要：目的探讨双能X线骨密度扫描(dual energy X-ray absorptiometry,DXA)技术诊断早期偏侧性帕金森病(Parkinson’s disease,PD)的临床价值。方法选取2019年9月至2022年3月就诊于上海健康医学院附属周浦医院诊断为早期偏侧性PD的患者80例为PD组,另选同期年龄、性别及体重指数(body mass index,BMI)相匹配的健康体检者60例为对照组。采用双能X线骨密度扫描仪测定所有纳入对象的股骨颈骨密度、髋部总骨密度、腰椎总骨密度,并检测血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]水平,比较两组骨密度、25(OH)D水平,分析PD组骨质疏松发生的危险因素。结果PD组腰椎总骨密度、股骨颈骨密度、髋部总骨密度、25(OH)D水平均低于对照组,差异有显著性(P<0.05)。PD组中27.5%(22例)患者出现骨质疏松,骨质疏松发生率高于对照组,差异有显著性(P<0.05)。多因素logistic回归分析显示年龄、女性、低BMI、低25(OH)D水平是早期偏侧性PD患者发生骨质疏松的危险因素。结论DXA能检测出偏侧性PD患者在病程早期阶段的骨密度,结合血清25(OH)D水平的降低等因素,对存在危险因素的患者应进行必要的早期预防和及时干预措施,以减少骨质疏松的发生,降低骨折风险。Objective To investigate clinical value of dual energy X-ray absorptiometry(DXA)in the diagnosis of early hemiparkinsonism.Method A total of 80 patients with early hemiparkinsonism were collected as the PD group,and 60 healthy subjects matched for age,sex and body mass index(BMI)were selected as the control group.Using dual energy X-ray bone mineral density scanner(LUNAR type),all observation objects measured femoral neck BMD,total hip BMD,total lumbar BMD,and detected serum 25 hydroxyvitamin D[25(OH)D]levels,compared BMD and 25(OH)D levels between the two groups,and analyzed the risk factors of osteoporosis in PD group.Result The BMD of lumbar spine,femoral neck,hip,and 25(OH)D levels in the PD group were lower than those in the control group,and the difference was statistically significant(P<0.05).Osteoporosis occurred in 27.5%(22 cases)of patients in the PD group,and the incidence of osteoporosis was significantly higher than that in the control group(P<0.05).Multivariate logistic regression analysis showed age,female,low BMI,and low 25(OH)D level were risk factors for osteoporosis in patients with early lateralized PD.Conclusion Dual energy X-ray bone densitometry scanner(LUNAR type)can detect that PD patients may have BMD in the early stage of the course of disease.Combined with multi factor analysis such as the reduction of serum 25(OH)D level,necessary early prevention and timely intervention measures should be taken for patients with risk factors,so as to reduce the occurrence of osteoporosis and reduce the risk of fracture.

关 键 词：早期偏侧性帕金森病 X射线 骨密度 25-羟维生素D 骨质疏松 

分 类 号：R445[医药卫生—影像医学与核医学]