定量CT骨密度测量应用于血压与腰椎骨密度相关性的研究

目的应用定量CT(QCT)测量腰椎骨密度(BMD),分析血压与腰椎BMD的相关性。方法选取2018年7月至8月本院体检中心的体检人群934例,男531例,女403例,年龄20~88岁,平均(49.47±11.90)岁,对其行胸部低剂量CT扫描,并测量腰椎BMD,根据QCT腰椎松质骨BMD分为骨量正常、低骨量、骨质疏松三组。并对体检者血压进行测量,根据中国高血压防治指南2018年修订版中的诊断标准,将体检者根据血压情况分为四类人群:血压正常人群、高血压1级人群、高血压2级人群、高血压3级人群,比较这四类人群骨代谢异常的发病率。结果三组间比较骨质疏松组中,女性所占比例较大(P<0.05);低骨量组及骨质疏松组的年龄明显大于骨量正常组(P<0.01);各组体重指数(BMI)比较差异没有统计学意义(P>0.05)。低骨量组及骨质疏松组的收缩压(SBP)、脉压(PP)大于骨量正常组(P<0.01);低骨量组及骨质疏松组的舒张压(DBP)大于骨量正常组(P<0.05)。四类人群中,高血压1级人群、高血压2级人群、高血压3级人群的低骨量和骨质疏松的发病率均高于血压正常人群(P<0.01),随着血压分级的增加,骨代谢异常(低骨量+骨质疏松)的发病率也在逐渐增加(P<0.01)。进一步行Pearson相关分析表明年龄、SBP、DBP、PP均与腰椎BMD呈负相关(P<0.01)。结论年龄、SBP、DBP、PP与腰椎BMD呈负相关;女性骨质疏松较男性明显;随着血压的增高,骨代谢异常的发病率也逐渐增高。

Application of Quantitative CT Bone Mineral Density Measurement in the Correlation between Blood Pressure and Lumbar Spine Bone Mineral Density

Objective Quantitative computed tomography(QCT)was used to measure the bone mineral density(BMD)of lumbar vertebrae,and the correlation between blood pressure and lumbar spine bone mineral density was analyzed.Methods A total of 934 subjects for physical examination were selected from July to August 2018.There were 531 males and 403 females,aged 20-88 years old,with an average age of 49.47±11.90 years.They underwent low-dose chest CT scans and lumbar spine bone mineral density was measured classified into three groups according to quantitative CT lumbar cancellous bone mineral density with normal bone mass,low bone mass and osteoporosis.The blood pressure of the medical examinee is measured.According to the diagnostic criteria in the revised version of the Chinese Hypertension Prevention Guide in 2018,the medical examiners are divided into four groups according to the blood pressure:normal blood pressure group,high blood pressure level 1 group,high blood pressure level 2 group,high blood pressure level 3 group.The incidence of abnormal bone metabolism was compared in these four groups of people.Results Among the three groups,the proportion of women in the osteoporosis group was larger(P<0.05);the age of low bone mass group and osteoporosis group was significantly higher than that of normal bone mass group(P<0.01);there was no significant difference in body mass index(BMI)between the groups(P>0.05).The systolic blood pressure(SBP)and pulse pressure(PP)in the low bone mass group and the osteoporosis group were larger than those in the normal bone mass group(P<0.01);the diastolic blood pressure(DBP)in the low bone mass group and the osteoporosis group was greater than normal bone mass group(P<0.05).Among the four groups of people,the low bone mass and the incidence of osteoporosis were higher in the hypertension level 1 group,the hypertension level 2 group,and the hypertension level 3 group than in the normal blood pressure group(P<0.01).With the blood pressure grading,the incidence of abnormal bone metabolism(low bone mass+osteoporosis)is also increasing(P<0.01).Further Pearson correlation analysis showed that age,systolic blood pressure,diastolic blood pressure,and pulse pressure were negatively correlated with lumbar spine BMD(P<0.01).Conclusion Age,systolic blood pressure,diastolic blood pressure,and pulse pressure are negatively correlated with lumbar bone density.In females,osteoporosis is more obvious than in male subjects.With the increase of blood pressure,the incidence of abnormal bone metabolism also gradually increases.