超高龄人群脊柱与髋部骨密度差异及其在髋部骨折风险评估中的价值  

Difference of spine and hip bone mineral density in the oldest old and its value in the risk assessment of hip fracture

作　　者：李龙域 冷子宽 李劲峰[1] 陈松峰 寇红伟[1] 尚国伟[1] 尚春风 苏会芳 宋宗冕 王义生[1] 时利军 刘宏建[1] Li Longyu;Leng Zikuan;Li Jinfeng;Chen Songfeng;Kou Hongwei;Shang Guowei;Shang Chunfeng;Su Huifang;Song Zongmian;Wang Yisheng;Shi Lijun;Liu Hongjian(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450052

出　　处：《中华实验外科杂志》2023年第1期169-172,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金面上项目(82172484)。

摘　　要：目的通过比较超高龄人群(年龄≥80岁)脊柱与髋部骨密度(BMD)差异,分析不同部位BMD在超高龄髋部骨折风险评估中的价值。方法采用回顾性研究方法,选取2017年11月至2022年2月在郑州大学第一附属医院骨科收治的超高龄髋部骨折患者52例作为观察组;选取同期体检中心超高龄体检患者52例作为对照组。通过组间比较分析两组患者一般资料、双能X线吸收检测法(DXA)测量得到的脊柱和髋部BMD差异;通过组内比较分析两组患者自身脊柱与髋部BMD的差异。计量资料采用t检验,计数资料采用χ^(2)检验。结果组间比较显示,观察组和对照组患者基线资料差异无统计学意义;观察组患者腰3椎体(L3)[(-2.7±1.5)比(-1.8±2.2),t=-2.275,P<0.05]、腰4椎体(L4)[(-2.4±1.5)比(-1.6±2.1),t=-2.137,P<0.05]、腰1~4椎体整体值(L1~4)[(-2.7±1.4)比(-2.0±1.9),t=-2.023,P<0.05]以及全髋部(TH)[(-3.0±1.1)比(-2.2±1.3),t=-2.618,P<0.05]BMD均低于对照组。组内比较显示,观察组患者L1 BMD低于TH BMD[(-3.630±1.209)比(-3.040±1.147),t=-2.313,P<0.05],对照组患者L3[(-1.753±2.249)比(-2.647±0.986),t=3.306,P<0.05]、L4[(-1.527±1.999)比(-2.647±0.986),t=4.830,P<0.05]及L1~4[(-2.183±1.828)比(-2.647±0.986),t=2.340,P<0.05]BMD均高于股骨颈(FN)BMD,L4 BMD高于TH BMD[(-1.527±1.999)比(-2.165±1.255),t=3.046,P<0.01]。结论超高龄髋部骨折患者腰椎部分节段和髋部BMD与同龄未骨折人群相比存在差异,该差异对超高龄人群髋部骨折风险预测有一定价值。Objective To analyze the value of bone mineral density(BMD)at different sites in the risk assessment of hip fracture by comparing spine and hip BMD in the oldest old(age equal to or older than 80 years).Methods The study followed a retrospective approach.A total of 52 oldest cases with hip fractures were included in the observation group and all of these patients were admitted to the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from November 2017 to February 2022.The other 52 oldest cases who underwent the physical examination at the examination center during the same period were selected as the control group.The difference of baseline data,spine and hip BMD measured by dual energy X-ray absorptiometry(DXA)between two groups were analyzed by comparison among groups.The difference of BMD at the spine and hip of cases themselves was performed by comparison within groups.Student’s t test was used for the measurement data and chi square test was used for the enumeration data.Results The comparison among groups showed that no statistically significant difference in baseline data was detected.The BMD of L3[(-2.7±1.5)vs.(-1.8±2.2),t=-2.275,P<0.05],L4[(-2.4±1.5)vs.(-1.6±2.1),t=-2.137,P<0.05],L1-4[(-2.7±1.4)vs.(-2.0±1.9),t=-2.023,P<0.05]and total hip(TH)[(-3.0±1.1)vs.(-2.2±1.3),t=-2.618,P<0.05]in the observation group were lower than those in the control group.The comparison within groups suggested that the BMD of L1 was lower than that of TH in the observation group[(-3.630±1.209)vs.(-3.040±1.147),t=-2.313,P<0.05].The BMD of L3[(-1.753±2.249)vs.(-2.647±0.986),t=3.306,P<0.05],L4[(-1.527±1.999)vs.(-2.647±0.986),t=4.830,P<0.05],L1-4[(-2.183±1.828)vs.(-2.647±0.986),t=2.340,P<0.05]was higher than that of femoral neck(FN)and the BMD of L4 was higher than that of TH[(-1.527±1.999)vs.(-2.165±1.255),t=3.046,P<0.01]in the control group.Conclusion There is difference in BMD of hip and partial segments of lumbar vertebrae between oldest patients with hip fractures and similar

关 键 词：超高龄人群 骨质疏松性骨折 髋部骨折 双能X线吸收检测法 骨密度 

分 类 号：R683[医药卫生—骨科学]