中老年女性腰椎、髋部、前臂骨密度和骨质疏松检出率的对比分析

目的 探讨中老年女性在应用双能X线骨密度仪检测不同部位骨密度时应关注检测的部位。 方法 选取2012年9月至2014年4月在我院行双能骨密度检测的中老年女性，比较腰椎、髋部、前臂桡骨下1/3的骨密度（BMD）和T值。结果 中老年女性腰椎、髋部、前臂桡骨下1/3 3个部位的BMD和T评分比较，P<0.001有显著差异。随着年龄逐渐增大，腰椎、髋部和前臂BMD逐渐降低，但70岁以后腰椎BMD趋于平稳。腰椎T评分在40岁和50岁年龄段下降幅度较快，60岁以后下降有所减缓，70岁以后趋于平稳。髋部T评分在各年龄段呈匀速下降。前臂T评分随着年龄的增大下降幅度明显大于腰椎和髋部。骨质疏松检出率也随年增加而增加，重度骨质疏松检出率也以前臂为最高。结论 应用双能X线骨密度仪检测腰椎、髋部、前臂3个部位，经比较发现老年女性前臂骨密度和T评分明显低于腰椎和髋部，提示对老年女性骨质疏松诊断应同时检测前臂骨密度，以免出现骨质疏松的漏诊。

Comparative analysis of bone mineral density of the lumbar spine, hip, forearm and osteoporosis detection rate in middle-aged women

Objective To investigate the detection sites of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) in the middle-aged women. Methods Middle-aged women who had BMD test using DEXA in our hospital from September 2012 to Apple 2014 were selected. BMD and T values of the lumbar spine, hip, and lower 1/3 of the forearm were compared. Results There were significant differences of BMD and T scores among 3 sites, the lumbar spine, hip, and lower 1/3 of the forearm, in middle-aged women (P<0.001). Along with the increase of age, BMD of the lumbar spine, hip, and forearm gradually decreased, but the BMD of the lumbar spine tended to be stable after 70 years of age. T-score of the lumbar spine declined rapidly at 40-50-year division, but the decline slowed after 60 years of age, and was stable after 70 years of age. T score of the hip declined evenly in all ages. Along with the increase of age, the decline of forearm T-score was significantly greater than that of the lumbar spine and the hip. The osteoporosis detection rate increased following aging. The detection rate of severe osteoporosis was the highest in the forearm. Conclusion BMD and T scores are significantly lower in the forearm, compared to those in the lumbar spine and the hip in middle-aged women, indicating that the forearm BMD should also be detected in middle-aged women to avoid misdiagnosis of osteoporosis.