DXA椎体骨折评估联合腰椎侧位骨密度诊断老年性骨质疏松的临床研究

Clinical evaluation of dual energy X-ray absorptiometry in the diagnosis of senile osteoporosis by lateral lumbar bone mineral density and vertebral fracture

    摘要
  • 摘要:
    目的研究双能X线吸收检测法（DXA）椎体骨折评估（VFA）联合腰椎侧位骨密度诊断老年性骨质疏松的效能。
    方法选取我院DXA同时检测髋部、腰椎前后位、腰椎侧位骨密度及VFA的老年受检者86例，根据DXA骨密度低下或VFA有脆性骨折诊断骨质疏松。比较腰椎侧位骨密度联合VFA与常规DXA检测髋部及腰椎前后位骨密度诊断骨质疏松的检出率。检出率的比较采用χ2检验。
    结果所有受检者中，常规DXA检测髋部及腰椎前后位诊断出骨质疏松患者58例（58/76，76.3%），侧位骨密度联合VFA诊断出骨质疏松患者76例（76/76，100%），二者检出率差异有统计学意义（χ2=10.617，P < 0.001）。其中，股骨颈骨密度诊断骨质疏松疏检出率（55.3%）高于髋部整体（34.2%），二者差异有统计学意义（χ2=6.812，P < 0.05）；髋部骨密度、腰椎前后位骨密度、腰椎侧位骨密度和VFA诊断骨质疏松症检出率分别为60.5%、47.4%、84.2%和78.9%，腰椎侧位骨密度与VFA的骨质疏松检出率比较，差异无统计学意义（χ2=0.700，P>0.05），但二者均高于髋部骨密度的骨质疏松检出率（χ2=10.66、6.110，均P < 0.05）。
    结论DXA检测腰椎侧位骨密度联合VFA对老年性骨质疏松的诊断具有重要价值，能够避免骨质疏松的漏诊。

     

    Abstract:
    ObjectiveTo study the sensitivity of vertebral fracture evaluation(VFA) combined with the use of lateral lumbar spine bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) in the diagnosis of senile osteoporosis.
    MethodsA total of 86 cases were collected using DXA to detect hip, lumbar spine, lateral lumbar spine BMD, and VFA simultaneously. Osteoporosis diagnosis was based on low-density DXA or VFA on fragile fracture. The osteoporosis detection rates between lateral lumbar spine BMD combined with VFA and conventional detection of DXA toward hip and lumbar BMD detection were compared by using chi-square test.
    ResultsAmong the subjects, 58 (76.3%) and 76 (100%) osteoporosis cases were detected by conventional DXA detection of hip and lumbar spine and lateral bone density combined with VFA. The osteoporosis detection rates of two groups were statistically significant (χ2=10.617, P < 0.001). The osteoporosis detection rate of femoral neck bone density(55.3%) was more than that of the whole hip (34.2%), and the difference was statistically significant (χ2=6.812, P < 0.05). The osteoporosis detection rates of hip BMD, lumbar orthotopic BMD, lateral lumbar spine BMD, and VFA were 60.5%, 47.4%, 84.2%, and 78.9%, respectively. The difference in the osteoporosis detection rates between lateral bone density and VFA was not statistically significant (χ2=0.700, P>0.05), but both rates were more than that of hip BMD (χ2=10.66, 6.110, both were P < 0.05).
    ConclusionThe detection of DXA toward lumbar lateral spine BMD combined with VFA is considerably significant in the diagnosis of senile osteoporosis. Therefore, the missed diagnosis of osteoporosis can be possibly avoided.

     

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