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41.
经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折 总被引:11,自引:2,他引:9
[目的]观察经皮椎体成形术(PVP)治疗疼痛性高龄骨质疏松性胸腰椎压缩骨折的临床疗效。[方法]在C臂X线透视监控下,以骨水泥(PMMA)为充填材料,经单侧或双侧椎弓根穿刺行PVP治疗6例、脊柱后凸成行术治疗2例。[结果]术中无骨水泥渗漏,术后患者疼痛明显缓解或消失,无1例出现严重并发症。[结论]PVP治疗疼痛性高龄骨质疏松性胸腰椎压缩性骨折是安全、有效、经济的。 相似文献
42.
目的 探讨血清瘦素水平对老年男性骨质疏松的影响。方法 选取年龄在60-92岁的158例老年男性,采用双能X线法(DXA)检测骨密度,并根据测值将受试者分为骨质疏松组与非骨质疏松组,用放射免疫法(RIA)检测两组空腹血清瘦素浓度,进行比较研究。结果 血清瘦素测值在不同年龄组间的差异无统计学意义,而在肥胖组与非肥胖组间有显著差异(P〈0.01)。在老年男性骨质疏松组血清瘦素测值明显低于非骨质疏松组,两者具有显著差异(P〈0.05)。结论 血清瘦索测值并不随老年男性的年龄而变化。但与老年男性的体重指数呈正相关,血清瘦素对老年男性骨质疏松有较好的预示及保护作用。 相似文献
43.
目的 总结治疗开放性骨质疏松性股骨远端骨折的治疗和应用伤害控制观念的体会。方法 回顾性分析2002年1月~2003年12月60岁以上股骨远端开放性骨折住院治疗的病例21例。应用伤害控制学的原则:全面评价其外伤程度,条件允许则急诊手术,危重患者就临时固定,监护患者的生理指标,限期施行骨折固定手术。结果 17例患者获得超过4个月以上的随访,平均随访7.3个月。17例患者在术后平均15周内(79~168d)达到临床愈合。参照Shelbourne疗效评定标准,膝关节功能优良率达到78%。结论 治疗开放性股骨远端骨质疏松性骨折需要应用伤害控制的观念,兼顾患者全面情况,同时治疗骨质疏松和其它并存疾病。手术固定以股骨髁上逆行交锁髓内钉为主,早期功能锻炼。 相似文献
44.
老年性骨质疏松脊柱良性骨折与转移瘤性骨折的MRI鉴别 总被引:13,自引:0,他引:13
目的探讨脊椎骨质疏松性压缩骨折的MRI表现及其与转移性压缩骨折的鉴别诊断.资料与方法回顾性分析53例老年性骨质疏松伴压缩性骨折和20例转移性椎体压缩骨折患者的MRI资料.全部病例均行常规MRI检查(矢状位、横轴位).分析两者引起的压缩骨折MRI征象,包括椎体和椎弓根的形态及信号改变、椎间盘增厚、椎体内真空现象和椎旁软组织形态.探讨两者之间的差别.结果两者在椎体和椎弓根形态及信号、椎体内真空现象、椎旁软组织形态上存在非常显著性差异(P<0.01).结论 MRI能准确显示骨质疏松性压缩骨折的形态及信号,与转移瘤之间有显著差异,大多能对二者做出鉴别诊断. 相似文献
45.
对氯烯雌酚醚防治雌性大鼠去势后骨丢失的评价 总被引:2,自引:0,他引:2
目的:了解氯烯雌酚醚对去势雌性大鼠骨代谢的影响。方法:鼠龄70天的Wistar雌鼠48只,分别予假性手术与注射用油(SV组)、去势与注射用油(OV组)、假性手术与氯烯雌酚醚(SE组)及去势与氯烯雌酚醚(OE组)等处理,双侧卵巢去势或假性手术后7天,于每晚腹腔注射氯烯雌酚醚或注射用油4ml/kg,共45天。处死大鼠时,测定子宫湿重,同时收集第12胸椎和左胫骨制成脱钙骨切片,行骨组织形态计量学测定。结果:4组间子宫重量差异均有显著性。骨组织形态计量学显示,(1)OV与SV、SE及OE组间差异有显著性;(2)OE、SE和SV组间差异无显著性。结论:氯烯雌酚醚能抑制Wistar雌鼠去势后的骨丢失,减缓去势后的子宫萎缩,对骨骼有雌激素样的保护作用。 相似文献
46.
The objective of this study was to estimate the incidence of hip fracture in the canton of Vaud, Switzerland (total population 584 000), for the period 1986–1991 using routine hospital discharge data collected by the Cantonal Service of Statistical Research and Information (SCRIS). For the survey period, the estimated average annual crude incidence rate of hip fractures was 167 per 100 000 persons aged 20 or older (241 for women and 84 for men). For the population aged 50 years or older, the crude incidence rate was 388 per 100 000 persons (546 for women and 185 for men). The average annual age-specific rates rose exponentially by successive 5-year age groups. The median age of patients at the time of the fracture was 82 years in women and 74 years in men. There was no significant difference between the total number of cervical and trochanteric fractures. Between the ages of 20 and 84 years, the cumulative risk for a woman to be admitted to hospital with a hip fracture was twice that of a man (15.8% vs 7.8%). From 1986 to 1991, the age- and sex-adjusted incidence, like the ratio of cervical to trochanteric fractures, did not show any significant trend, although it was consistent with an increase in men (p=0.09). However, the annual number of fractures rose from 644 to 776, particularly among very aged men. The mean length of stay in the acute care hospital fell from 38 days in 1986 to 25 days in 1991. Finally, the comparison of these results with those obtained in 1986 for the same population from more exhaustive sources has confirmed the provision of a consistent, although overestimated, assessment of hip fracture incidence by means of these routine hospital statistics in the canton of Vaud, Switzerland. 相似文献
47.
Differences in hip axis and femoral neck length in premenopausal women of Polynesian, Asian and European origin 总被引:4,自引:0,他引:4
There are substantial inter-racial differences in hip fracture incidence. Studies in several different ethnic groups have suggested that differences in the length of the femoral neck may contribute to these. The present study assesses femoral neck and hip axis lengths in three ethnic groups in which it has not been documented previously (Chinese, Indians and Polynesians) and compares these values with those in Europeans. Lengths were measured from dual-energy X-ray absorptiometry scans of the proximal femur in normal premenopausal women (n=225). The Polynesian (1.65 m) and European (1.64 m) women were significantly taller than the two Asian groups (mean height in each, 1.58 m). There were also differences in mean body weight, the Polynesians being the heaviest (76 kg) and the Chinese the lightest (53 kg). Femoral neck lengths were (mean + SD) Chinese 61.5+4.4 mm, Indian 61.5+5.1 mm, Polynesian 68.2+4.3 mm and Europeans 66.0+4.8 mm. Hip axis lengths were Chinese 98.0+5.6 mm, Indian 94.5+5.2 mm, Polynesian 106.4 ± 5.3 mm and European 102.3+5.3 mm. Each of the other groups were significantly different from the Europeans for both variables and, in general, this remained so after height adjustment. These data suggest that shorter femoral necks are common to the major Asian racial groups. However, in contrast to all other ethnic groups studied, Polynesians have longer femoral necks than Europeans and their low incidence of hip fracture is not explicable, therefore, in terms of their femoral neck length. This suggests that either higher bone density or other more subtle differences in proximal femoral geometry must account for the low hip fracture incidence in Polynesians. 相似文献
48.
Agents for prevention or treatment of osteoporosis must now be tested in a large animal species that exhibits bone remodeling.
Ovariectomized, nonhuman primates provide one such model, and they consistently develop osteopenia accompanied by high bone
turnover rates. The goal of this study was to further characterize this model, and particularly to determine the effect of
ovariectomy on bone strength in vertebrae and femoral necks. Longitudinal evaluations of spinal bone mass and serum markers
of bone turnover were performed in 19 sham-ovariectomized (SHAM) and 18 ovariectomized (OVX), domestically reared cynomolgus
monkeys, aged >9 years. OVX monkeys lost bone relative to both baseline values and SHAM controls. Serum markers of bone turnover
were increased by OVX. After 72 weeks, both vertebral bone compressive strength and femoral neck breaking strength were significantly
decreased in OVX animals compared with SHAM. Ovariectomized cynomolgus monkeys, like postmenopausal women, develop accelerated
bone loss, increased bone turnover, and reduced bone strength, and provide a suitable large animal model for efficacy studies
with agents for prevention or treatment of osteoporosis.
Received: 24 June 1996 / Accepted: 3 September 1996 相似文献
49.
Angelo Cagnacci Gian Benedetto Melis Renza Soldani Anna Maria Paoletti Marco Gambacciani Adriana Spinetti Piero Fioretti 《Maturitas》1991,13(4):283-296
The neuroendocrine and clinical effects of transdermal 17β-estradiol (rated at 50 μg/day; TTS 50) were studied in 40 postmenopausal women; ten additional postmenopausal women did not receive any drugs. The changes in LH and rectal temperature induced by the infusion of the opioid antagonist naloxone (10 mg i.v. bolus plus 10 mg/h for 4 h) were used to evaluate the central activity of endogenous opioid peptides. TTS 50 increased opioid activity, as evidenced by the restoration of the LH response (P < 0.01) and the enhancement of the hypothermic effect (P < 0.05) of naloxone. A greater reduction in hot flushes was observed in TTS 50-treated subjects than in untreated women, with the maximal effect of TTS 50 achieved after 3 months of therapy. TTS 50 did not modify the concentrations of circulating lipids, glucose or liver enzymes but reduced the biochemical parameters indicative of bone reabsorption. Bone density of the distal radius significantly increased during TTS 50 (P < 0.02), reaching its maximum value after 6 months of therapy. Thereafter bone density declined, but more slowly than in untreated women.
Our data suggest that TTS 50 has marked neuroendocrine effects, that it diminishes the incidence of hot flushes and reduces bone demineralization. By contrast, it has a very little, if any, metabolic impact on the liver or on glucose and lipid metabolism. 相似文献
50.
M. Kneissel P. Roschger W. Steiner D. Schamall G. Kalchhauser A. Boyde M. Teschler-Nicola 《Calcified tissue international》1997,61(2):95-100
There is abundant data on cancellous bone in the aging human spine, but little relating to the growing vertebral cancellous
bone in childhood and adolescence. The purpose of this study was to map vertebral cancellous bone in a growth and age series
of historic skeletal samples and to make comparisons with data published on recent material. Lumbar vertebral bodies were
collected from 65 skeletons (0–60 years) from a medieval Nubian population. Ethnohistoric information was collected to interpret
conditions that might have influenced bone structure and metabolism. The cancellous bone was studied three dimensionally,
using stereophotography and scanning electron microscopy and morphometrically by performing a semiautomatic structural analysis
on digitized backscattered electron images of polymethacrylate-embedded material. The cancellous bone structure in the children
consisted mainly of a densely packed, uniform network of small rodlike trabeculae. The greatest bone volume fraction with
small, more platelike trabeculae was observed during adolescence. In young adults, larger platelike trabeculae were present
in the central zone and smaller trabeculae in the superior and inferior zones, as described for modern skeletal material.
Structural changes associated with aging were observed much sooner than in modern man. By the estimated age of approximately
50–60 years, the predominant architectural elements were slender rarified rods in both sexes. The ethnohistorical data suggest
that this was essentially a black African population of physically active peasants, not likely to suffer Vitamin D insufficiency
or deficient calcium intake. Thus an earlier onset of the biological age changes in cancellous bone found in modern populations
was probably prevalent.
Received: 1 March 1996 / Accepted: 31 December 1996 相似文献