腰椎滑脱症患者的骨密度变化分析

目的探讨不同时期脊柱滑脱症患者的骨密度变化规律。方法对105例腰椎滑脱症患者的腰椎骨密度进行测量,依据不同的滑脱分型,进行结果对比分析。结果腰椎滑脱症患者平均骨密度较同年龄组正常值偏低。随病程的延长和年龄的增长,腰椎滑脱症患者骨密度均降低(P<0.01);骨质疏松组假性滑脱发生率明显高于非骨质疏松组(P<0.01);骨质疏松组发病部位以L5滑脱多见,非骨质疏松组发病部位以L4、L5滑脱为主(P<0.05)。结论骨质疏松症与腰椎滑脱有一定因果关系,两者互相影响,脊柱滑脱患者要防止骨质疏松症的发生,预防骨质疏松症将有助于防止假性脊柱滑脱的发生。     

运动对绝经后女性骨密度的影响

目的：观察运动对绝经后女性骨密度的影响。方法：绝经后女性106名分为运动组37例和对照组69例。运动组进行广场舞、爬山、慢跑等运动干预,对照组未进行任何干预。采用双能X线吸收仪测试其全身及各部位骨矿含量（BMC）和骨密度（BMD）,并进行比较。结果：运动干预8个月后,运动组全身BMD和BMC值均较干预前及对照组明显增加（P＜0．05）,而对照组全身BMD和BMC值均较8个月前下降,但差异无统计学意义。运动组胸椎的BMD、BMC和盆骨的BMC均较干预前及对照组明显增加（P＜0．05）,而腰椎的BMD、BMC和盆骨的BMD干预后差异无统计学意义;对照组干预后腰椎、盆骨的BMD、BMC均较8个月前明显下降（P＜0．05）,而胸椎的BMD、BMC 8个月前后差异无统计学意义。运动组上肢优势侧BMD、BMC和下肢双侧BMD、BMC均较干预前及对照组明显增加（ P＜0．05）,而上肢非优势侧BMD、BMC干预前后差异无统计学意义;对照组上肢非优势侧BMD、BMC均较8个月前及上肢优势侧BMD明显下降（P＜0．05）,而上肢优势侧BMC和下肢双侧BMD、BMC 8个月前后差异无统计学意义。结论：常规运动可显著提高绝经后女性胸椎 BM D和BM C ,而只能维持其腰椎和盆骨的BM D、BM C;上下肢、优势侧与非优势侧活动不均衡可影响相关部位 BM D和BM C的变化。     

女性腰椎侧位与后前位骨密度的相关性研究

目的分析女性腰椎侧位与后前位骨密度(BMD)的相关性,探索女性腰椎骨密度的变化规律。方法观察166名45~70岁的女性无骨质疏松症状健康体检者,使用GE Lunar Prodigy型双能骨密度仪测量观察对象的腰椎后前位BMD(L2-4BMD)、侧位BMD(B2-4BMD),根据是否绝经及L2-4BMD是否正常,将观察对象分为4组,即未绝经L2-4BMD正常组、未绝经L2-4BMD异常组、绝经后L2-4BMD正常组、绝经后L2-4BMD异常组,分析L2-4BMD、B2-4BMD及其与年龄、体质量指数等的相关关系,并建立回归方程。结果在L2-4BMD正常组,绝经者BMD与未绝经者比较有显著差异,绝经后BMD明显降低;在L2-4BMD异常组,绝经者BMD与未绝经者比较,L2-4BMD明显降低,B2-4BMD无显著差异。各组B2-4BMD与L2-4BMD均具有显著相关关系。绝经后L2-4BMD正常组B2-4BMD与绝经年数的相关有显著统计学意义。多元回归分析显示,因变量B2-4BMD(y)主要由L2-4BMD(X1)、绝经年数(X2)、体质量指数(X3)决定,各组具有相应的回归模型:绝经后L2-4BMD正常组、绝经后L2-4BMD异常组、未绝经L2-4BMD正常组、未绝经L2-4BMD异常组,其B2-4BMD的回归方程分别为:r=0.147+0.501X1-0.007X2,y=-0.437+0.457X1+0.024X3,y=0.102+0.559X1,y=-0.350+0.947X1。结论女性B2-4BMD与L2-4BMD有显著相关关系;女性B2-4BMD与是否绝经、L2-4BMD是否正常有关,绝经后女性更应当早期检查骨密度。     

腰椎各椎体松质骨密度分析及皮/松比值意义

目的:分析腰椎(L1~L4)各椎体松质骨密度(BMD)的差异及皮/松(骨皮质与骨松质BMD之比)比值与骨质疏松的关系。材料与方法:对在我科进行骨密度检查的20~80岁人群,符合条件的被测者554例,男231例,女323例,除外各种器质性内分泌、消化系统及肿瘤等疾病,用QCT及标准软件测量腰椎BMD,通过计算机分析比较各椎体骨松质BMD值有无差异(采用SPSS软件做统计学分析)以及皮/松比值与骨质疏松的关系。结果:男女两性别各年龄组各椎体(L1~L4)骨松质BMD值无明显差异(P>0.05)。腰椎骨松质BMD值随着年龄增加而减小,同时腰椎骨皮质与骨松质BMD比值随年龄增加而增大,二者呈显著的直线相关(男性:r=0.944,P<0.05;女性:r=0.932,P<0.05)。结论:腰椎各椎体(L1~L4)骨松质BMD值无明显差异(P>0.05);腰椎骨皮质与骨松质比值增大提示骨质疏松的存在和腰椎退行改变的程度。     

Effects of alendronate and risedronate on bone mineral density and bone turnover markers in late postmenopausal women with osteoporosis

This study was undertaken to compare the effects of alendronate and risedronate on bone mineral density (BMD) and bone turnover markers (BTMs) in late postmenopausal women with osteoporosis. Thirty women older than 60 y of age were randomly assigned to receive alendronate 10 mg (n=16) or risedronate 5 mg (n=14) on a daily basis. The patients were followed every 3 mo for 12 mo. BMD measurements were taken at baseline and at the end of the study, and BTMs were measured at 3-mo intervals. By the end of the study, there were statistically significant increases in BMD in both groups at all sites at which they were measured (P < .001). However, these differences were not statistically significant between groups. By the end of the study, all BTMs had decreased significantly and to a similar extent in both groups. The most significant change was observed in the third month of the study. A negative correlation was noted between percentage change in bonespecific alkaline phosphatase and femoral neck BMD (r=-0.467). This study reported no difference between the 2 drugs in their effects on BMD and BTMs.     

Pamidronate increases bone mineral density in women with postmenopausal or steroid-induced osteoporosis

INTRODUCTION: We aimed to determine the efficacy and safety of a cyclic intravenous therapy with pamidronate in patients with postmenopausal or glucocorticoid-induced osteoporosis. METHODS: We enrolled 86 Austrian female patients with postmenopausal (n = 69, mean age 68.13 +/- 1.14) or glucocorticoid-induced (n = 17, mean age 66.89 +/- 2.03) osteoporosis defined as a T-score of < -2.5 for bone mineral density (BMD) of the lumbar spine L1-L4. Patients received a single intravenous dose of 30 mg pamidronate at 3 months intervals. The per cent change in BMD was primary, whereas the safety and the biological response were secondary endpoints. RESULTS: Seventy-six female patients (88%) completed study. Sixty patients received pamidronate therapy for the treatment of late postmenopausal osteoporosis and 16 patients received the same treatment for glucocorticoid-induced osteoporosis. At the end of the trial, lumbar spine (L1-L4) BMD increased significantly in patients with postmenopausal osteoporosis (P = 0.000067), whereas in patients with glucocorticoid-induced osteoporosis no significant change was observed (P = 0.724). The increase in the Ward's triangle BMD did not reach significance level in postmenopausal women receiving pamidronate (P = 0.0740). However, pamidronate treatment for glucocorticoid-induced osteoporosis resulted in a significant increase in Ward's triangle BMD (P = 0.0029). The efficacy of pamidronate treatment for postmenopausal osteoporosis was also reflected in a decrease in circulating biochemical markers for bone formation, including alkaline phosphatase and osteocalcin. In addition, pamidronate was well tolerated with no incidence of severe gastrointestinal events. CONCLUSION: Cyclic intravenous administration of pamidronate is well-tolerated therapy in postmenopausal osteoporosis, and increases spinal BMD. Randomized controlled studies with adequate number of patients are needed to test the efficacy of the compound in the treatment of glucocorticoid-induced osteoporosis.     

Serum osteopontin levels in relation to bone mineral density and bone turnover markers in postmenopausal women

Osteopontin (OPN) is an extracellular matrix protein that is expressed in bone cells such as osteoblast and osteocytes and associated with bone turnover and bone mineral density (BMD) in postmenopausal women. Here, we aimed to investigate the relationship between circulating OPN levels and BMD in postmenopausal women in Southern China. A total of 362 postmenopausal women were consecutively recruited into this study from 2011–2013. Serum levels of OPN, receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL), and bone turnover markers were analyzed. BMD was measured by dual energy X-ray absorptiometry. Osteoporosis and osteopenia were diagnosed according to the World Health Organization criteria. Serum OPN levels were remarkably higher in the osteoporotic group than those in the osteopenic and normal groups (all p?r?=??0.25, p?=?0.004; r?=??0.66, p?r?=??0.28, p?=?0.001; respectively) and positively associated with type I procollagen amino-terminal propeptide (PINP), carboxy-terminal cross-linking telopeptide of type I collagen (CTX), and RANKL (r?=?0.20, p?=?0.020; r?=?0.17, p?=?0.036; r?=?0.19, p?=?0.028, respectively) in the osteoporotic group. In multiple regression analyses, lumbar spine BMD, PTH and RANKL were the predictors for serum OPN levels. In conclusion, OPN serum levels are negatively related to BMD and positively correlated with bone turnover levels in this group of Chinese postmenopausal women.     

老年知识分子骨密度影响因素286例研究

目的：探讨影响老年知识分子骨密度的因素及防治老年骨质疏松的措施。方法：采用整群抽样方法对两所高等院校２８６例（男１０３例，女１８３例）５０岁以上老人进行骨密度及相关因素调查。结果：随着年龄增长，骨密度呈现明显下降趋势。老年女性较男性骨密度下降显著。适度运动及经常饮用牛奶可促使骨密度增高。结论：运动及合理膳食有预防老年骨密度下降的作用     

骨密度对腰椎矢状位力线和椎间盘退变程度的影响分析简

目的 研究骨密度对腰椎椎体矢状位力线及椎间盘退变程度的影响情况.方法 回顾性分析46例老年腰椎病患者的术前腰椎MRI资料,根据双能X线吸收仪（DXA）测量的左侧股骨颈骨密度结果将患者分为三组：骨密度正常组（17例）、骨量减少组（19例）和骨质疏松组（10例）,从腰椎矢状位MRI上测量和比较各组患者的腰椎椎体前、中、后高以及各椎间盘的前、中、后高,记录和比较各组患者腰椎各椎间盘退变程度（采用Pfirrmann分级）.结果骨质疏松组和骨量减少组腰椎各椎体高度无显著统计学差异（P＜0.05）,但都明显低于骨量正常组,其中椎体前高、中高的降低具有显著性差异（P＜0.05）.骨质疏松组在下腰段椎间盘（腰3-4、腰4-5、腰5-1）中高有增加趋势,但骨质疏松组各椎间盘的后高都显著低于骨量减少组及骨量正常组（P＜0.05）.骨质疏松组椎间盘信号退变程度要明显优于骨量减少组及骨量正常组（P＜0.05）.结论 骨密度情况不仅对腰椎椎体矢状位形态产生影响,而且还对椎间盘矢状位形态和退变程度产生影响,骨质疏松症患者有椎间盘退变减缓的趋势.     

低强度复合振动联合阿仑膦酸钠对绝经后骨质疏松患者骨密度的影响研究

目的:观察低强度全身复合振动(whole-body vibration,WBV)联合阿仑膦酸钠(alendronate,ALE)对绝经后骨质疏松患者骨密度的影响情况。方法:选择2014年8—12月门诊绝经后骨质疏松患者60例,随机分为WBV治疗组、ALE治疗组和WBV+ALE治疗组,每组20例;WBV治疗组是给予全身低强度复合振动(振动强度为0.5—0.8g,频率为45—55Hz,每次振动30min,每天1次,每周5次,周末休息2天,共6个月);ALE治疗组是每周口服1次阿仑膦酸钠70mg;WBV+ALE治疗组是给予全身复合振动及阿仑膦酸钠治疗。然后使用双能X线吸收骨密度仪测定所有志愿者治疗前后腰椎及髋部的骨密度。结果:(1)腰椎骨密度在WBV治疗6个月后增加3.72%,ALE治疗组增加4.55%,WBV+ALE治疗组增加7.16%,三组治疗方法之间有显著性差异(P0.05)。(2)髋部Neck骨密度,WBV治疗6个月后增加2.24%,ALE治疗组增加3.43%,WBV+ALE治疗组增加7.22%,三组治疗方法比较有显著性差异(P0.05)。(3)大转子骨密度,WBV治疗6个月后增加2.10%,ALE治疗组增加4.90%,WBV+ALE治疗组增加7.63%,三组治疗方法之间比较有显著性差异(P0.05)。(4)髋部Wards三角骨密度,WBV治疗6个月后增加5.00%,ALE治疗组增加7.13%,WBV+ALE治疗组增加9.04%,三组治疗方法之间比较有显著性差异(P0.05)。结论:WBV、ALE和WBV+ALE三种治疗方法均能改善绝经后老年妇女腰椎及髋部的骨密度,其中低强度WBV联合ALE能够更好提高绝经后腰椎及髋部BMD,可以为临床上绝经后骨质疏松的防治工作提供一种新的思路。     

糖皮质激素治疗对青春期肾小球疾病患者骨密度的影响

目的 探讨糖皮质激素（GC）治疗对青春期肾小球疾病患者骨密度（BMD）的影响因素和治疗方法.方法 49例（14～19）岁的肾小球疾病患者,应用常规剂量GC治疗,于治疗前和治疗后的每3～6个月,检测第2～4腰椎（L2～4）和股骨近端BMD;其中BMD降低明显的14例加用伊班膦酸钠治疗.结果 ①青春期患者L2～4和股骨近端骨量分别约占峰值骨量的83%和90%.②用GC治疗15个月后,男性各部位和女性L2～4骨丢失7.3%～21.3%,BMD较治疗前明显降低（P＜0.005）.③男性各部位、女性L2～4骨密度与体质量和身高,男性L2～4与年龄均正相关（P均=0.000）.男性近端股骨BMD与GC用量和用药时间负相关（rs=-0.296,-0.290,P＜0.05）.④用伊班膦酸钠4个月后骨量增加1.9%～4.2%,以L2～4BMD增加明显.⑤随访17个月无自发性骨折病例.结论 青春期骨量是峰值骨量的83%～90%;长期口服GC导致与GC用量和用药时间相关的骨丢失,男性更突出.伊班膦酸钠可防治GC所致的BMD减低.     

Effects of levothyroxine suppressive therapy on bone mineral density in premenopausal women

BACKGROUND: Levothyroxine (L-T4) is widely prescribed for treating thyroid disorders, but its effect on bone mineral density (BMD), is being debated. OBJECTIVES: We studied the effect of supraphysiologic doses of L-T4 on BMD in a group of premenopausal women. PATIENTS AND METHODS: We included 50 women (mean age=36.8 +/- 7.6 years) receiving L-T4 for at least 1 year for treating their benign cold thyroid nodules. Serum T3, T4, thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), calcium, and phosphate and urine calcium and sodium levels of all patients were measured. Bone density at femoral neck and lumbar (L1-L4) regions was measured, using dual energy X-ray absorptiometry (DXA). RESULTS: No significant decrease was detected in the bone density of the subjects treated with L-T4 compared with the control group. CONCLUSION: L-T4 treatment for 1 year is not associated with increased risk of osteoporosis in premenopausal women but other potential adverse effects still need to be monitored in women receiving L-T4 especially long-term.     

黔江区正常人群骨密度调查研究

目的：了解黔江区健康成年人骨密度变化规律及骨质疏松患病情况,指导骨质疏松症的防治。方法应用美国 LUNAR Prodigy 双能 X 线骨密度仪（DXA）,测量1110例（男483例,女627例）20岁以上黔江区居民腰椎正位（L1～4）骨密度（BMD）。结果（1）黔江区健康男性腰椎骨密度峰值出现在30～34岁年龄组;女性骨密度峰值出现在35～39岁年龄组。女性45岁以后骨密度明显下降（P ＜0．01）,男性60岁以后骨密度明显下降（P ＜0．05）。（2）黔江区50岁以上健康男性腰椎骨质疏松患病率为13．2％,女性腰椎骨质疏松患病率为42％;男性腰椎骨量减少患病率为34．9％。女性腰椎骨量减少患病率为38．5％。（3）与其他年龄组比较,50～54岁组、55～59岁组女性的骨质疏松患病率增高（P ＜0．01）,但60岁以后无明显差异,男性相邻年龄组患病率无明显差异;50～54岁、55～59岁组同龄男女患病率差异无统计学意义,60岁以后女性患病率高于男性（P ＜0．01）。结论（1）黔江区骨质疏松症防治形势严峻;（2）减少女性 OP 患病率,围绝经期干预极为关键。     

Comprehensive osteoporosis management with easy access to bone mineral density measurements

Background The majority of people with osteoporosis are never evaluated even though effective treatments are available. The County Council of Värmland in Sweden has implemented an osteoporosis management model that has been shown to be effective in promoting awareness and providing care for osteoporosis patients. Discussions among a prevention group on osteoporosis in the county council were opened in 1997. The county of Värmland covers a large area, and the distances from the peripheral parts to the main city are approximately 300 km and cumbersome for the inhabitants. The importance of having an osteoporosis service that could reach the county inhabitants in a convenient way was therefore recognized. Methods Three thousand four hundred patients were evaluated between March 2001 and December 2003. Guidelines for patient selection for bone density testing and treatment guidelines were formulated. Promoting awareness was an important prerequisite for the model to function. This was accomplished by having the measurement devices where the patients showed up and by regular education of the primary care doctors. Results and conclusions A multidisciplinary team was established and consisted of primary care doctors, orthopaedic surgeons, internists, physiotherapists, a patient organization member, a county health care representative and nurses. Team members met every third month and agreed upon clinical guidelines for implementing the system. The presented osteoporosis management system is not a screening approach as all patients had risk factors for osteoporosis before they were suggested for bone density testing. This study shows that providing a comprehensive package of measures makes it possible to establish an effective osteoporosis management system with limited economical resources.     

99Tcm-MDP骨显像腰椎标准摄取值与骨密度的相关性

目的 观察不同骨密度（BMD）患者⁹⁹Tc^m-亚甲基二磷酸盐（⁹⁹Tc^m-MDP）骨显像腰椎标准摄取值（SUV）的差异，并分析其与BMD的相关性。方法 回顾性分析62例接受⁹⁹Tc^m-MDP全身骨显像、腰椎SPECT/CT断层显像及双能X线腰椎BMD检测患者，根据BMD结果将其分为骨量正常组（n=18）、骨量减低组（n=24）和骨质疏松组（n=20），比较3组腰椎平均SUV（SUV_mean）、最大SUV（SUV_max）及BMD等的差异，分析其与腰椎平均CT值、患者年龄、体质量及身高的相关性。结果 腰椎SUV_max和SUV_mean分别为7.39±1.84和4.90±1.27，均与BMD呈正相关（r=0.64、0.63，P均<0.01）。腰椎SUV_max、SUV_mean和BMD均与年龄呈负相关（r=-0.33、-0.44、-0.43，P均<0.05），与体质量（r=0.42、0.30、0.35）及平均CT值（r=0.56、0.59、0.73）呈正相关（P均<0.05），与身高无明显相关（P均>0.05）。3组间腰椎SUV_max、SUV_mean、BMD和平均CT值差异均有统计学意义（F=24.09、30.50、94.85、30.24，P均<0.01）。骨量减低组腰椎SUV_max、SUV_mean、BMD和平均CT值明显低于正常组（P均<0.01）；骨质疏松组明显低于骨量正常组和骨量减低组（P均<0.01）。结论 ⁹⁹Tc^m-MDP骨显像腰椎SUV可用于评价骨质疏松及评估疗效。腰椎SUV_max及SUV_mean均与BMD呈正相关。骨质疏松患者腰椎SUV_max和SUV_mean明显降低。     

Serum and urine markers of type I collagen metabolism in elderly women with high and low bone mineral density

The serum markers of bone formation (carboxy-terminal propeptide of type I collagen, PICP) and resorption (pyridinoline cross-links containing telopeptide of type I collagen, ICTP), as well as urinary resorption markers, pyridinoline (Pyr) and deoxypyridinoline (Dpyr), were studied in 78-year-old women with high ( n  = 18) and low ( n  = 17) bone mineral density (BMD) measured from the calcaneus and tibia. The low-BMD group had higher values for PICP ( P  = 0.025), Pyr ( P  = 0.001) and Dpyr ( P  < 0.001) than the high-BMD group. No inverse relationship between these markers and BMD was, however, observed within the study groups. ICTP, Pyr and Dpyr correlated with each other in both groups and with PICP in the high-BMD group. Higher levels of both the formation and resorption markers of type I collagen suggest an increased rate of bone turnover and remodelling in osteopenic elderly women.     

Correlation of quantitative heel ultrasonography with central dual-energy X-ray absorptiometric bone mineral density in postmenopausal women.

OBJECTIVES: In this study, we sought the proper cutoff level for quantitative ultrasonography (QUS) of the heel in identifying bone mineral density (BMD) categories as determined by dual-energy x-ray absorptiometry (DXA) in postmenopausal women. METHODS: With the use of DXA, BMD categories of the lumbar spine and different areas of the left femur of 420 healthy women according to World Health Organization definitions were determined. Quantitative ultrasonography of the heel was also performed in each subject. Receiver operating characteristic curves were plotted, and sensitivity and specificity of QUS to diagnose osteoporosis were examined at different points to identify the best cutoff level. The diagnostic agreement between the two techniques in identifying osteoporosis was assessed with kappa scores. RESULTS: The kappa scores were 0.31 for the lumbar region and 0.5 for the femoral neck region. On the receiver operating characteristic study, a score of -1 was found to be the appropriate cutoff point for QUS studies, in which the sensitivity of QUS to diagnose BMD osteoporosis varied between 78% and 87.5% depending on the site of the DXA study. With the proposed cutoff point (-1), sensitivity and specificity of QUS in detecting osteoporosis at the lumbar spine were 83.9% and 51%, respectively, and at the femoral neck were 84% and 50%, respectively. CONCLUSIONS: Insufficient agreement between QUS and DXA led to uncertainty on expected BMD in people tested by QUS. The proposed cutoff value could achieve higher sensitivity but only by accepting higher rates of false-positive results.     

兰州市区汉族、回族正常人群骨密度研究

目的 通过测量兰州市区1865例次汉族、回族健康人群的骨密度(bone mineral density,BMD),确定本地区汉族、回族BMD的正常参考值范围,并比较研究汉族、回族BMD随年龄变化的规律.方法 使用X线骨密度仪(prodigy DPX-NT型美国GE-Luner公司)测定兰州市区20～75岁以上的汉族、回族健康人群的腰椎和股骨BMD,按不同性别每5岁分为一年龄组,得出BMD均值、标准差.结果 汉族、回族男性及女性各部位出现骨峰值的年龄段略有不同,腰2～4椎体汉族、回族男性及女性基本在30～35岁左右达到骨峰值,汉族、回族男性及女性的股骨颈骨峰值在25～30岁年龄组,汉族、回族男性及女性的大转子骨峰值在20～25岁年龄组,汉族、回族男性及女性的Ward三角区骨峰值在25～30岁年龄组,但多数均在40岁前随骨量逐渐增加而达到骨峰值.其后随年龄的增长BMD降低,女性BMD在50岁后加速下降.男性无加速下降的趋势.结论 本研究建立了兰州市区汉族、回族各年龄段BMD的正常值参考范围,为今后骨质疏松的预防、诊断、研究提供了客观数据和比较的依据.     

脑卒中偏瘫患者骨密度变化及继发骨质疏松症的特点

目的：探讨脑卒中患者肢体瘫痪对其骨密度（BMD）和骨质疏松（OP）患病率的影响。方法：102例广东省佛山地区常住的脑卒中患者（脑卒中组），男46例，女56例，年龄55—85岁（平均72.8±9.2岁），使用美国 Hologic公司双能X线骨密度仪对正位腰椎（L1-L4）、双侧前臂远端和股骨近端进行BMD测定，并与352例本地区健康人（对照组）进行BMD及OP患病率的比较。结果：脑卒中组的偏瘫侧前臂、股骨颈、Ward′s区的BMD值明显低于健侧（0.444±0.11 vs 0.478±0.09，0.716±0.16 vs 0.757±0.16, 0.373±0.15 vs 0.407±0.15, P<0.05），偏瘫侧股骨颈、Ward′s区和腰椎BMD明显低于对照组（0.716±0.16 vs 0.844±0.12, 0.373±0.15 vs 0.495±0.13, 0.768±0.18 vs 0.831±0.13, P<0.05）。病程≥3个月的患者的偏瘫侧前臂、股骨颈和腰椎BMD明显低于病程<3个月的患者（0.415±0.10 vs 0.474±0.11，0.672±0.16 vs 0.751±0.16，0.722±0.14 vs 0.802±0.19，P<0.05），且病程≥3个月的患者的健侧BMD也低于病程<3个月的患者，但差异没有显著性（P>0.05）。女性脑卒中患者各部位的BMD明显低于男性（P<0.05）。脑卒中组偏瘫侧股骨的OP患病率高于健侧（P<0.05），男性腰椎和股骨、女性股骨的OP患病率高于对照组（P<0.05）。结论：脑卒中后偏瘫患者患侧前臂、股骨近端和腰椎BMD度低于健康人和健侧；女性患者BMD低于男性患者，病程越长，BMD越低。患侧肢体OP患病率高于健侧，脑卒中患者股骨的OP患病率高于健康人。     

利维爱对绝经后妇女骨密度及骨代谢指标的影响

目的了解利维爱对绝经后妇女骨密度及骨代谢指标的影响 . 方法将 123例自然绝经后妇女随机分 2组 研究组每日口服利维爱 1.25 mg+ 钙尔奇 D 600 mg, 对照组每日口服钙尔奇 D 600 mg, 观察 12个月 . 用药前后分别检测腰椎 (L 2～ 4)及股骨颈 (NK)骨密度 (BMD)骨代谢指标血清骨钙素 (BGP)和碱性磷酸酶 (AKP)及尿吡啶酚 /肌酐 (Pyr/cr)和钙 /肌酐 (Ca/Cr)比值 . 结果 (1)L 2～ 4、 NK两部位 BMD 研究组治疗后均增加 , 且前者上升有显著性差异 (P< 0.05);对照组均下降无显著性差异 (P >0.05);治疗后 2组间比较有显著性差异 (P< 0.01,P< 0.05). (2)生化指标血 BGP、 AKP及尿 Pyr/Cr、 Ca/Cr 治疗后研究组均上升有显著性差异 (P< 0.01,P< 0.05); 对照组变化无显著性差异 (P >0.05). 结论绝经后妇女每日服用 1.25 mg利维爱加钙尔奇 D可以提高骨量 ; 单用钙尔奇 D不能防止骨丢失 .