超声骨密度检测在骨质疏松症诊断中的应用  

Application of ultrasonic detection of bone mineral density in the diagnosis of osteoporosis

作　　者：苏其昌 梁江声 SU Qichang;LIANG Jiangsheng(Department of Orthopaedics,the Third People's Hospital of Shunde District,Foshan,Guangdong 528300,China)

机构地区：[1]佛山市顺德区第三人民医院骨科,广东528300

出　　处：《中国骨科临床与基础研究杂志》2024年第2期121-125,共5页Chinese Journal of Orthopaedic Clinical and Basic Research

基　　金：佛山市卫生健康局医学科研课题项目(20230819A010153)。

摘　　要：目的分析广东佛山北滘镇中老年居民的骨量情况,评价超声骨密度检测在骨质疏松症诊断中的价值。方法选取2022年8月至2023年10月于佛山市顺德区第三人民医院体检的200例北滘镇中老年居民,使用双能X线吸收测定法(DXA)对体检者腰椎进行测量,同时使用定量超声系统(QUS)对体检者右侧桡骨远端进行测量,采用Pearson分析两种测量值的相关性,并以DXA-T值作为骨质疏松症的诊断标准,通过绘制受试者工作特征曲线(ROC)评价桡骨QUS-T值对骨质疏松症的诊断价值。结果200例体检者中有33.0%罹患骨质疏松,47.0%骨量减少,且随着年龄的增长,骨量逐渐减少(趋势χ^(2)=124.779,P<0.001)。Pearson相关分析显示,桡骨QUS-T值与DXA-T值呈正相关(r=0.183,P<0.05)。ROC曲线显示,桡骨QUS-T值诊断骨质疏松症的曲线下面积为0.542,最佳截断值为﹣2.7,敏感度和特异度分别为72.7%、38.8%。男性受试者桡骨QUS-T值诊断骨质疏松症的曲线下面积为0.708,最佳截断值为﹣2.7,敏感度为62.8%,特异度为66.7%;女性受试者桡骨QUS-T值诊断骨质疏松症的曲线下面积为0.630,最佳截断值为﹣1.03,敏感度为87.0%,特异度为47.9%。结论广东佛山北滘镇中老年居民的骨质疏松症发病率高于全国平均水平。尽管QUS骨密度检测结果不能作为骨质疏松的诊断标准,但在社区筛查中有较高的参考价值,值得推广应用。Objective To analyze the bone mass of middle-aged and elderly residents in Beijiao Town of Foshan City,and to evaluate the value of ultrasonic detection of bone mineral density(BMD)in the diagnosis of osteoporosis.Methods A total of 200 middle-aged and elderly residents in Beijiao Town who underwent physical examination in the Thrid People's Hospital of Shunde District from August 2022 to October 2023 were selected.BMD of lumbar vertebra of the subjects was determined by dual-emission X-ray absorptiometry(DXA),at the same time,BMD of the right distal radius of the subjects was measured by quantitative ultrasound system(QUS),and the correlation between the two measurements was analyzed by Pearson analysis.Using DXA-T value as the diagnostic criterion for osteoporosis,the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of radial QUS-T value for osteoporosis.Results Among the 200 subjects,33.0%had osteopo-rosis and 47.0%had osteopenia,and the bone mass decreased gradually with the increase of age(trendχ^(2)=124.779,P<0.001).Pearson analysis showed that the radial QUS-T value was positively correlated with the DXA-T value(r=0.183,P<0.05).The ROC curve showed that the area under the curve of radius QUS-T value in diagnosing osteoporosis was 0.542,the optimal cut-off value was﹣2.7,the sensitivity was 72.7%and the specificity was 38.8%.For male subjects,the area under the curve of radial QUS-T value in the diagnosis of osteoporosis was 0.708,the optimal cut-off value was﹣2.7,the sensitivity was 62.8%and the specificity was 66.7%.For female subjects,the area under the curve of radial QUS-T value in the diagnosis of osteoporosis was 0.630,the optimal cut-off value was﹣1.03,the sensitivity was 87.0%and the specificity was 47.9%.Conclusions The incidence of osteoporosis among middle-aged and elderly residents in Beijiao Town of Foshan City is higher than the national average.Although the results of BMD detection of QUS can't be used as a diagnostic criterion for osteoporosis,it

关 键 词：骨质疏松 骨密度 超声检查 吸收测定法 光子 桡骨 普查 

分 类 号：R681.4[医药卫生—骨科学] R445.1[医药卫生—外科学]