绝经后脊柱骨质疏松症的临床研究

目的调查绝经后脊柱骨质疏松症（PSO）的发病率，建立PSO骨量参考值数据库，为PSO的诊断、选择治疗方式和疗效评估提供依据。方法随机收集绝经后X线影像学提示椎体骨疏松352例，用单光子吸收法（SPA）检测跟骨骨量，提示骨质疏松的称真性PSO，资料和数据存于电脑进行统计学分析。结果真性PSO 232例（占总数的65．91％），骨量112．82～250．82mg／cm^2，平均191．55mg／cm^2。352例中45岁以下年龄组32例（9．09％），均因肿瘤、妇科疾病等原因致双侧附件过早切除而较早绝经；45～55岁组60例（17．05％）；56～65岁组92例（26．14％）；66～75岁组124例（35．23％）；75岁以上年龄组44例（12．50％）。结论单凭DR—X线影像学不能确定真性PSO，诊断PSO，X线影像学应结合骨量检测；全身各骨骼骨量的丢失率是不同步的，对各部位骨骼的骨质疏松的诊断应有所区别，并合理命名；真性PSO应根据椎体形态、个数和节段来确定椎体成形术的适应证；绝经后不进行医疗干预，骨量丢失速度会更快；对PSO应采取综合保守治疗的方式积极干预。

A clinical investigation on postmenopausal spine osteoporosis

Objective To establish data bank of postmenopausal spine osteoporosis （PSO）, and analyse the synchronism of bone quantity（BQ） loss of the skeleton,and its clinical value, and the incidence relationship between working, sports and PSO. Methods Right calcaneus of no injury 352 cases postmenopansal women, age ranged 25 - 96 years, average age 68.73 years ; DR-X ray imaging demonstration classic spine osteoporosis suffering from simple waist-back pain were measured by single photon absorptiometry （SPA）. Results PSO 232 cases （account for sum total 65.91% ）, measured BQ between 112. 82 - 250. 82 mg/cm^2 , average 191.55 mg/cm^2 ;Under aged 45 years 32 cases, early menopause because of the removal of bilateral ovary suffering with tumour; Aged 45 to 55 years 60 cases; Aged 56 to 65 years 92 cases; Aged 66 to 75 years 124 cases; Over aged 75 years 44 cases. The true incidence rate of PSO was 65. 91%. Conclusions The true PSO couldn＇t been diagnosed with individual DR-X ray imaging or SPA. It was necessary to combine DR-X ray imaging with SPA in the diagnosis of the true PSO. BQ loss of the skeleton of all body wasn＇t a synchronous. It would been differentiated the individual osteoporosis from the osteoporosis of all body or PSO, and been named rationally. The indication of vertebroplasty would been operated in accordance with vertebral deformity and it＇s amount of the vertebral body cursh fracture. BQ loss of the skeleton was more quick, and would been intervene with clinic medical method more early at menopause or postmenopausal women.