深圳地区妇女腰椎骨矿含量标准定量CT观察

背景目前有较多测量骨矿含量的方法,但不同的方法所反映的测量部位、临床应用价值及对正常人群同骨质疏松症的鉴别能力有所不同.目的观察深圳地区妇女腰椎骨矿含量,建立正常骨矿含量定量CT标准,为临床预防及指导治疗该地区骨质疏松提供依据.设计以正常妇女为研究对象,随机化同期对照,观察对比研究.单位一所区级医院医学影像科.对象选择2000-09/2002-03本深圳市龙岗区中心医院的体检深圳地区妇女120例为研究对象,年龄30～69岁.将研究对象分成30～39,40～49,50～59,60～69岁4个年龄组,每组30例.方法利用定量CT软件测量研究对象的骨矿质含量,从而确定深圳地区妇女骨矿质含量标准,并与其他地区妇女的骨矿质含量进行对照分析.主要观察指标观察深圳地区妇女骨矿质含量平均值,并与国内外其他地区进行比较.结果定量CT测量结果与灰重呈直线相关,并可用如下直线回归方程表示灰重=0.92432×骨矿含量+39.0633.深圳地区绝经期前后妇女各年龄组腰椎骨矿含量丢失率逐渐增加,松质骨、密质骨平均年丢失率1.38%,0.84%.深圳地区50～59组妇女骨矿含量(135.31±18.36)mg/cm3]明显高于长春地区、北京地区、美国妇女(20.21±37.40),(116.7±26.6),(119.5±27.1)mg/cm3](t=2.002,3.383,3.636,P＜0.05～0.01);深圳地区30～39岁组妇女骨矿含量明显高于美国妇女(t=3.119,P＜0.01);各地区其他年龄段妇女骨矿含量比较,无明显差异(P＞0.05).结论使用定量CT建立了该地区绝经期前后妇女正常骨矿含量标准,为骨质疏松症的预防、干预、预后和骨折危险性的评价提供基本标准.

Lumbar bone mineral content in Shenzhen women by quantitative computerized tomography

BACKGROUND: Bone mineral content(BMC) can be determined by many methods, which are different in detecting position, clinical significance and differentiation between normal group and people with osteoporosis.OBJECTIVE: To establish a normal BMC standard by observing lumbar BMC with quantitative computerized tomography(QCT) measurement in Shenzhen women, so as to provide basis for clinical prevention and treatment of osteoporosis in the region.DESIGN: Randomized controlled, observational and comparative study taking normal women as subjects.SETTING: Medical imaging department of a hospital at district level.PARTICIPANTS: A total of 120 women aged 30 to 69 years, who received physical examination in the Central Hospital of Longgang district in Shenzhen from September 2000 to March 2002, were enrolled in this study. They were divided into four groups: 30 - 39 age group, 40 - 49 age group, 50 - 59 age group and 60 - 69 age group with 30 in each.METHODS: Trabecular and cortical BMC of lumber bodies(L1-3) were measured with QCT software so as to establish a standard of normal BMC in Shenzhen women and compare it with that of other regions.MAIN OUTCOME MEASURES: The mean BMC in Shenzhen women, and comparison with that of other regions at home and abroad.RESULTS: The results of QCT showed linear correlation between BMC and bone ash weight, which could be expressed by the following linear regression equation: ash weight =0. 92432 × BMC + 39. 0633. Lumbar BMC loss increased with age in Shenzhen perimenopausal women. The annual loss of spongy bone and compact bones was 1.38% and 0. 84%, respectively. BMC of women aged 50 to 59 years was (135.31 ± 18.36) mg/cm3], obviously higher than that of women in Changchun city, Beijing city and the United States (120.21 ±37.40), (116.7 ±26.6), and(119.5 ±27.1) mg/cm3]( t = 2. 002, 3. 383, 3. 636, P ＜ 0.05 - 0. 01 ) . Moreover, BMC of women aged 30 to 39 years was also obviously higher than that of corresponding American women( t = 3.119, P ＜ 0.01 ). No significant difference was found in BMC among women of the other age groups in these regions( P ＞ 0. 05).CONCLUSION: This is the first time in our country to establish a standard of normal BMC in perimenopausal women with QCT measurement, which provides basis for early prevention and treatment of osteoporosis as well as evaluation of prognosis and fracture risk.