首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 15 毫秒
1.
绝经后骨质疏松症患者骨密度及骨代谢参数的调查研究   总被引:10,自引:1,他引:10  
目的 了解E2和IL-6在骨质疏松症发病中的作用。方法 选择绝经后妇女120例,绝经后有骨质疏松60例(OP组),绝经后无骨质疏松60例(NOP组),另外选择绝经前妇女60例为对照组。对180名妇女雌二醇(E2)、骨密度(BMD)、白细胞介素-6(IL-6)、血清总碱性磷酸酶(ALP)、骨钙素(BGP)、尿羟脯氨酸肌酐比值(尿Hoc/Cr)、尿钙肌酐比值(尿Ca/Cr)等指标进行了测定。结果 绝经后妇女骨形成指标BGP及ALT明显高于对照组妇女,其中ALP在OP组和NOP组间有差异,而BGP在OP组和NOP组间无差异;绝经后妇女骨吸收指标尿HOP/Cr及尿Ca/Cr明显高于对照组妇女,OP组尿HOP/Cr及尿Ca/Cr又明显高于NOP组;绝经后妇女的血清E2的含量明显低于对照组(绝经前妇女),OP组又明显低于NOP组;绝经后妇女血清IL-6的含量明显高于对照组妇女,而OP组又明显高于NOP组。结论 本研究证明E2、IL-6与骨质疏松关系密切,雌激素水平的下降,IL-6分泌增多,是导致骨吸收加速的重要原因之一。  相似文献   

2.
骨密度测量技术诊断骨质疏松的评价   总被引:4,自引:1,他引:3       下载免费PDF全文
骨矿密度(BMD)是诊断骨量减少(低骨量,骨质疏松),评价骨丢失率和疗效的重要客观指标。被世界卫生组织(WHO)用来定义骨质疏松(OP)的诊断标准。目前非创伤性骨密度测量方法主要有以下几种:X线光密度法(RA),单光子吸收法(SPA),双光子吸收法(DPA),双能x线吸收测定(DEXA),定量CT(QCT)。不同的测量方法的优、缺点和临床意义不同,在此简要综述几种BMD测量方法和特点。  相似文献   

3.
阿伦膦酸盐对绝经后骨质疏松妇女骨密度的影响   总被引:1,自引:0,他引:1  
为了解阿伦膦酸盐对骨密度的影响及其安全性和耐受性,对20名绝经后骨质疏松的妇女中进行阿伦膦酸盐(alendronate)10mg/天和安慰剂的随机、双盲、前瞻性研究,为期一年。结果显示,1年后阿伦膦酸盐组与安慰剂组相比,骨密度平均增长率:椎骨分别为4.87%与-0.23%;股骨颈分别为6.89%与-1.84%,(P<0.05)。副反应仅为轻微胃肠道反应。结论:阿伦膦酸盐能有效增加骨密度,且药物安全,耐受性好  相似文献   

4.
Corticosteroid-induced osteoporosis, which particularly affects the axial skeleton and the proximal femur, is characterized by a state of low bone remodelling. Fluoride is a potent stimulator of trabecular bone formation which could potentially be useful in the treatment of corticosteroid-induced osteoporosis. We investigated the effects of sodium monofluorophosphate (26 mg/day of fluoride) combined with 1000 mg of calcium (MFP-calcium-treated group), or of calcium alone (control), given for 18 months, on bone mineral density (BMD) of lumbar spine (LS), femoral neck (FN) and midfemoral shaft (FS) in 48 patients with corticosteroid-induced osteoporosis. Mean ages were 49.4±3.1 and 51.6±3.0 years (mean± SEM), duration of corticosteroid therapy 7.5±1.8 and 9.3±1.7 years, and mean daily dose of prednisone 18.2±2.3 and 12.1±1.1 mg in the MFP-calcium-treated group and controls, respectively. Initial BMDs (expressed as theZ-score, i.e. the difference in standard deviations from age- and sex-matched normal subjects) were –1.5±0.2 and –1.2±0.2 for LS, –1.4± 0.2 and –1.3±0.2 for FN, and –0.8±0.3 and –0.6±0.3 for FS, in the MFP-calcium-treated group and controls, respectively. Analysis by linear regression of 6-monthly measurement values revealed BMD changes of +7.8 ±2.2 versus + 3.6±1.3% (p<0.02) for LS, –1.5±1.8 versus +0.9 ±1.8% for FN, and –1.1±1.1 versus –0.5±1.4% for FS after 18 months of follow-up in the MFP-calcium-treated group and controls, respectively. For comparison, 17 patients with idiopathic osteoporosis (mean age 63.9±2.0 years), with initial BMDs of –1.3±0.4, –1.6±0.3 and –0.8±0.4 (Z-score for LS, FN and FS, respectively), received MFP and calcium for 22.1±1.7 months. BMD changes in idiopathic osteoporosis were +9.3±2.7% (p<0.005), –1.3±2.0% and +0.6± 0.9% for LS, FN and FS, respectively. These results indicate that the combination sodium monofluorophosphate and calcium was more efficient than calcium alone in increasing lumbar spine BMD in patients with corticosteroid-induced osteoporosis; neither femoral neck nor femoral shaft BMD was affected. Moreover, these effects were similar in patients with corticosteroid-induced and idiopathic osteoporosis.  相似文献   

5.
体积骨密度的估算方法及其对诊断骨质疏松的意义   总被引:1,自引:0,他引:1       下载免费PDF全文
骨密度(BMD)有面积骨密度(aBMD)和体积骨密度(vBMD)两种表达方式,它们在临床实验研究中被广泛采用。本文综述了vBMD的估算方法、aBMD和vBMD存在的性别差异和种族差异,以及aBMD和vBMD对诊断骨质疏松的影响。  相似文献   

6.
The assessment of bone mineral density (BMD) is the usual study to detect patients at risk for developing osteoporosis. The aim of this study was to compare the discriminative ability of total body BMD and its different subregions with the more usual measurements of BMD of the lumbar spine and femoral neck in women with osteoporotic fractures of the spine. The BMD was determined in 61 osteoporotic (at least one vertebral wedge fracture visible in the lateral X-ray film of the thoracic or lumbar spine) and 61 age-matched control women. Measurements were made by dual X-ray absortiometry (DXA) with a total body scanner. The BMD of the osteoporotic women was significantly lower at all skeletal areas compared with control (P<0.001). The diminution was less pronounced but still significant at the arms (P<0.05). The areas with the largest Z score in the osteoporotic group were antero-posterior lumbar spine (-1.78), femoral neck (-1.71), legs (-1.67), and total body (-1.59). There was no significant difference among the Z scores of the four above-mentioned measurements. The Z score of the arms (-0.79), spine (-1.12), and head (-1.29) were significantly lower than the Z score of the total body. The Z score of the pelvis was lower than the Z score of the total body but the difference only approached statistical significance (0.05> P<0.1). The Z score of the anteroposterior lumbar spine (-1.78) was compared with the Z score of the total (-1.12) lumbar (-0.93) and thoracic (-1.38) spine obtained as subregions of the total body. The best differentiation of the two populations was found by measuring the antero-posterior lumbar spine directly (P<0.01-P<0.001). In conclusion, the diagnostic differentiation of the total body BMD is similar to that of the anteroposterior lumbar spine and proximal femur measurements. In addition, the measurement of the total body BMD has a lower error and enables simultaneous evaluation of the different subregions of the skeleton as well as the body composition. The BMD of the spine as a subregion of the total body cannot replace the direct evaluation of the anteroposterior lumbar spine.  相似文献   

7.
目的探讨老年男性骨质疏松患者血清胰淀素(Amylin)水平的变化及其与骨密度(BMD)及骨转换生化指标的关系。方法采用酶联免疫法(ELISA)测定89例老年男性骨质疏松患者和50例正常男性老年人血清Amylin、骨碱性磷酸酶(BAP)、骨钙素(BGP)、I型胶原氨基末端肽(NTX),采用美国NORLAND XR-46 Excell-plus双能X线骨密度测定仪分别测定正位腰椎(L2-L4)及左侧股骨颈BMD。结果老年男性骨质疏松患者正位腰椎及左侧股骨颈BMD、血清Amylin、BAP、BGP水平较正常男性老年人明显降低(均P<0.01),血清NTX水平较正常男性老年人明显升高(P<0.01)。老年男性骨质疏松患者血清Amylin水平与患者正位腰椎及左侧股骨颈BMD、血清BAP、BGP水平呈明显正相关(r=0.598,r=0.652,r=0.576,r=0.584,均P<0.01),与患者血清NTX水平呈明显负相关(r=-0.673,P<0.01)。结论血清胰淀素水平降低在老年男性骨质疏松的发病中可能发挥重要作用。  相似文献   

8.
目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者骨密度(bone mineral density,BMD)及骨代谢指标的相关影响因素,观察运动频率对RA伴发骨质疏松(osteoporosis,OP)患者BMD及骨代谢指标的影响。方法回顾性分析45例初诊RA患者的性别、年龄、病程、超敏C反应蛋白(high-sensitivity C-reactive protein,HS-CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、抗环瓜氨酸肽抗体(anti-cyclic cirullinated peptide antibodies,抗CCP抗体)、RA疾病活动性评分(DAS28评分)等指标,观察这些临床因素对RA患者的BMD及血清骨代谢指标的影响。血清骨代谢指标包括β-胶原降解产物(β-C-terminal telopeptide region of collagen type1,β-CTX)、总Ⅰ型胶原氨基端延长肽(I pro collagen N-terminal pro peptide,PINP)、骨钙素(osteocalcin,OC)、25羟维生素D[25-(OH)D],通过电话回访RA患者的康复运动情况,分析运动频率对RA伴OP患者骨密度及骨代谢指标的影响。结果本组RA伴发OP的发生率为46.67%,BMD的下降以腰椎、股骨颈最明显。BMD的改变与年龄、病程、DAS28评分相关,随着年龄的增长、病程的延长、DAS28评分的升高,BMD降低(P0.05)。骨吸收指标β-CTX在年龄≤65岁组、病程≤0.5年组、抗CCP抗体阳性组均升高,差异有统计学意义(P0.01,P0.05);骨形成指标PINP、OC在年龄≤65岁组、抗CCP抗体阳性组均升高,差异有统计学意义(P0.05);25-(OH)D水平在DAS28评分2.6组高于DAS28评分≥2.6组,差异有统计学意义(P0.05)。RA伴OP患者中,经常运动组的全身及腰椎BMD、PINP、OC均高于不运动组,差异有统计学意义(P0.05,P0.01);PINP、OC与经常运动呈正相关(P0.05),β-CTX与抗CCP抗体呈正相关(P0.01)。多元线性回归分析显示全身BMD受血清25-(OH)D水平及运动频率影响明显,随着血清25-(OH)D水平及运动频率的提高,全身BMD呈增加趋势。结论 RA伴发OP的发病率高,骨密度与年龄、病程、疾病的活动、25-(OH)D水平、运动频率相关。RA伴发OP属于高转换型骨代谢异常,在疾病早期、活动期骨破坏和骨形成均加快。运动可促进骨形成、提高骨密度,建议临床应重视在内科治疗基础上的运动治疗。  相似文献   

9.
目的 调查长春市16019例汉族人群骨密度,分析本地区峰值骨量及骨密度变化的人群规律.方法 采用美国Osteometer Medi Tech公司生产的DTX-200型骨密度仪,检测受试者非受力侧前臂桡尺骨远端三分之一处骨密度(BMD).将16019例检测结果按不同性别每5岁为一年龄组,应用SPSS 13.0软件统计分析骨密度均值、T评分及骨量丢失百分率.结果 长春市男、女性人群骨密度峰值分别为0.625±0.109、0.506±0.058,其峰值年龄为30~39岁年龄段,40岁以后开始缓慢下降,50~59岁年龄段男性骨质疏松发病率为7.7%,女性为6.97%;60~69岁年龄段男性骨质疏松发病率为18.13%,女性为35.97%;70~79岁年龄段男性骨质疏松发病率为36.41%,女性为59.55%,80岁以上男性骨质疏松发病率为57.53%,女性为75.56%.结论 不同年龄及同年龄组两性之间比较骨密度测定值差异显著(P<0.01).50岁以后各年龄段女性骨质疏松发病率明显高于男性(P<0.01).本研究报告的骨密度峰值高于日本、丹麦同类型骨密度仪检测结果;与北京地区骨密度检测结果相近.与西双版纳傣族、西藏、甘肃东乡族比较,差异显著(P<0.01).  相似文献   

10.
目的探讨骨胶原含量在绝经后骨质疏松症的发生、发展及在骨质疏松性骨折中的作用。方法取7个月龄未交配雌性SD大鼠60只,随机分为四组,A组:对照组(sham组);B组:切除卵巢组;C组:切除卵巢+雌激素治疗组;D组:切除卵巢+降钙素治疗组。除A组外,其他三组通过切除双侧卵巢法12周后制成骨质疏松模型,24周后分别行k的力学特性、右侧股骨三点弯曲试验、羟脯氨酸含量、k骨密度(BMD)测定,Masson三色染色法显示骨胶原形态。结果A、C、D组与B组在k羟脯氨酸含量、BMD、k压缩力学参数值、右侧股骨生物力学参数值、骨胶原染色含量及形态方面差异均有统计学意义(P〈0.05),而A、C、D组之间差异无统计学意义(P〉0.05)。统计学分析显示羟脯氨酸含量与BMD及骨生物力学参数值呈直线相关性。结论骨质疏松的发生与骨胶原含量下降有关。骨胶原含量的下降与BMD降低及骨生物力学改变呈相关性。应用雌激素和降钙素治疗去势后骨质疏松大鼠,不仅可以提高其BMD含量和骨生物力学性能,而且还可以提高骨胶原的含量。  相似文献   

11.
目的 为探讨消化性溃疡(溃疡病)对患者骨密度(BMD)的影响。方法本文采用双能X 线骨密度仪(DEXA)测定了114 例溃疡病患者腰椎及右股骨上端(Neck、W ard 三角、Troch)的骨密度。结果 从疾病、性别、年龄、体重指数(BMI)等方面将溃疡病患者BMD 的变化与相匹配的正常对照组BMD 进行分析比较,发现溃疡病患者BMD 广泛低于对照组,以腰椎改变具有显著差异(P<0.01)。结论 溃疡病患者存在明显骨丢失,其骨质疏松症(OP)患病率为男31.03% 、女42.86% 。  相似文献   

12.
目的:探索强直性脊柱炎(ankylosing spondylitis,AS)患者发生骨密度异常的危险因素。方法:调查选取2018年5月~2019年5月来本院就诊的AS患者年龄、病程、血沉(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)等炎症指标和枕墙距、胸廓活动度等体格检查情况。选取同期健康人作为对照组。使用双能X线骨密度吸收仪测定AS患者及对照组股骨颈、大转子、腰椎及全髋关节骨密度情况,并采用独立样本t检验进行组间差异性比较。同时采用Pearson相关性分析,探索AS患者各部位骨密度异常情况与病程、年龄、炎症指标等的相关性,采用多元线性回归分析AS骨密度异常的危险因素。结果:本次研究共纳入23例AS男性患者,平均年龄36.6±5.9岁,20名健康成年男性对照,平均年龄38.9±4.0岁(P>0.05)。病例组中位病程5(3,7)年。病例组股骨颈(0.86±0.17)、大转子(0.85±0.12)、腰椎(0.90±0.10)、全髋关节(0.88±0.16)骨密度均低于对照组(0.98±0.21、...  相似文献   

13.
广州地区1 530例骨密度分析及骨质疏松发病率研究   总被引:6,自引:1,他引:6       下载免费PDF全文
目的为了解广州地区正常人群骨密度(BMD)的变化规律和骨质疏松(OP)的患病率.方法采用美国Lunar公司的双能X线骨密度仪对广州地区1 530名20~89岁居民进行腰椎2-4和髋部骨密度测量.结果男性腰椎骨密度峰值在20~29岁,女性腰椎骨密度峰值在30~39岁,男性与女性髋部骨密度峰值均在30~39岁,峰值后随年龄增加而骨密度下降,女性在50~59岁出现明显加速,男性没有加速下降现象.广州地区男性50~89岁骨质疏松患病率26.53%,女性50~89岁骨质疏松患病率42.64%,两者之间差异有非常显著性(P<0.01).结论广州地区女性骨质疏松患病率高于男性,预防骨质疏松的重点在女性,但对男性骨质疏松患者也不容忽视.  相似文献   

14.
目的 为了确定前臂骨密度的遗传因子,对来源于96个核心家庭的218名后代进行了常染色体基因组扫描,旨在研究前臂骨密度与染色体的连锁证据。方法 应用荧光标记引物对367个常染色体基因组微卫星生物标记物进行基因型测定,应用pDXA法测定前臂近端与远端的骨密度。结果 前臂骨密度与D2S2141,D2S1400,和D2S405,以及前臂远端骨密度与D13S788和D13S800具有连锁关系。结论 在中国人群中经性别、年龄调整后的前臂骨密度与第2和13号染色体某些区域相关。  相似文献   

15.
目的研究骨密度对骨质疏松性骨折的判断价值。方法共3组研究对象,398例骨质疏松不伴有骨折的研究对象(A组),胸腰椎骨折患者(B组),骨密度正常的正常组进行研究。研究骨密度的一般情况、不同T值在各组的分配情况,骨质疏松性骨折与骨密度(BMD)的相关性。结果腰椎L2-L4、L2-L4和股颈的BMD值之间,T值人数分配之间,正常组、A组以及B组的差别具有统计学意义(P<0.05)。腰椎L1-L4、L2-L4和股颈的BMD以及总BMD的测定值均与骨质疏松性骨折相关。结论我们认为:本地区所收治的骨质疏松性骨折患者,全部应诊断判定为骨质疏松症。  相似文献   

16.
The significance of variability in bone mineral density (BMD) between lumbar vertebrae L1 to L4 in the same individual was investigated by dual-energy X-ray absorptiometry in 1000 normal women aged 40–60 years (average 52 years) and 145 women aged 45–80 years (average 65 years) with vertebral osteoporosis. The mean BMD increased from L1 to L4 in normal women from 0.841 g/cm2 to 1.017 g/cm2, and in osteoporotics from 0.562 g/cm2 to 0.709 g/cm2.Z scores for osteoporotic women (Z = osteoporotic BMD — age-normal BMD/normal SD) were significantly lower for individual vertebrae compared with Ll–4 and at L4 compared with L1, L2 and L3 (p<0.001). The mean difference betweenZ scores for the highest and lowest vertebrae in an individual was 0.70 for normals (SD=0.40) and 0.64 for osteoporotics (SD=0.36). The mean Z score difference between the L1–4Z score and the lowest individual vertebralZ score was 0.36 for normals (SD=0.23) and 0.06 for osteoporotics (SD=0.31). However, receiver operating analysis (ROC) curves showed that the lowestZ score for any individual vertebra did not provide improved discrimination between normals and osteoporotics when compared with the L1–4Z score. The area under the ROC curve for L1–4 was significantly greater than for individual vertebrae (p<0.05) and that for L4 was significantly smaller than for L1, L2 or L3 (p<0.001). In conclusion, L1–4 BMD gives greater diagnostic sensitivity for osteoporosis than individual vertebrae, and L1, L2 and L3 are better than L4. Although there is considerable individual variation inZ scores for different vertebrae in the same individual, the lowest vertebralZ score does not offer improved diagnostic sensitivity over the L1–4Z score.  相似文献   

17.
目的 观察贵州地区驻军部队退休干部骨密度(BMD)的变化规律及骨质疏松症的发病率,为部队老干部保健过程中骨质疏松症的防治提供参考依据.方法 随机抽取贵州地区2009~2011年来我院体检的退休干部455例,采用双能X线骨密度仪行BMD测定,以同部位、同性别峰值BMD减低2SD作为诊断骨质疏松标准,按性别、年龄分组进行统计学分析.结果 贵州地区部队退休干部各部位骨密度随年龄增高而逐渐下降,且女性的骨量丢失速率明显高于男性.骨质疏松发病率女性高于男性,Ward's区骨质疏松发生率显高于其他部位.结论 本研究分析了贵州地区部队退休干部骨密度及骨质疏松发病率的变化规律,为贵州地区部队退休干部保健过程中骨质疏松症的防治提供了参考依据.  相似文献   

18.
目的 分析浙北地区人群骨密度(BMD)变化规律及骨质疏松(OP)患病率。方法 使用美国进口的Dove3000骨密度仪对浙北地区20~93岁的居民6330人进行跟骨BMD测定,然后进行比较和统计分析。结果 男女性骨峰值在30—39岁年龄段,峰值后随年龄增长BMD逐渐下降,女性在50岁后可见明显的骨质丢失加速,而男性丢失是逐渐和缓慢的。浙北地区50~79岁人群骨质疏松症发病率男性为35.8%,女性为67.3%。结论 骨质疏松研究的重点在中老年妇女,但对于男性也不能忽视;骨质疏松的预防应从青少年开始。  相似文献   

19.
目的研究骨疏宁片联合阿托伐他汀对2型糖尿病合并绝经后骨质疏松症患者骨密度及骨代谢的影响。方法 124例2型糖尿病合并骨质疏松症妇女随机分为治疗组和对照组,治疗组进行骨疏宁片联合阿托伐他汀治疗,对照组单纯予以阿托伐他汀治疗。治疗前及治疗后12个月分别检测两组受试者腰椎1~4和左侧股骨颈骨密度、VAS疼痛评分以及骨代谢指标。结果治疗前,各组受试者骨密度、VAS疼痛评分以及骨代谢指标比较无统计学意义(P0.05)。治疗6个月及12个月,两组患者VAS评分不同程度降低,其中以治疗组骨痛的治疗效果要明显优于对照组(P0.05)。治疗12个月两组L1~4椎体、股骨颈的BMD明显升高(P0.05),而治疗组明显高于对照组(P0.05)。治疗12个月,两组血清I型胶原N端前肽(type 1 collagen N terminal peptide,P1NP)的水平明显升高,而I型胶原羧基末端肽(type I collagen carboxy-terminal peptide,CTX)水平明显下降,和对照组比较,治疗组血清P1NP及CTX水平改变更为明显(P0.05)。结论骨疏宁片联合阿托伐他汀可以显著提高2型糖尿病合并骨质疏松症女性骨密度及降低VAS评分,且能改善2型糖尿病合并绝经后骨质疏松症患者骨代谢异常,值得临床推广。  相似文献   

20.
Bisphosphonate is an effective drug to reduce fracture risk in osteoporotic patients; however, factors affecting the efficacy of bisphosphonate treatment are not fully known, especially in Japanese patients. In the present study, we examined the relationships between an increase in lumbar spine bone mineral density (BMD) by bisphosphonates and several pretreatment parameters, including biochemical, bone/mineral, and body composition indices, in 85 postmenopausal osteoporotic patients treated with alendronate or risedronate. BMD increase was measured by dual-energy X-ray absorptiometry at the lumbar spine before and 2 years after treatment. BMD increase at the lumbar spine was observed as independent of age, height, weight, body mass index, and fat mass, although lean body mass seemed slightly related. On the other hand, fasting plasma glucose (FPG) levels were significantly and positively related to BMD increase at the lumbar spine. In multiple regression analysis, FPG levels were not significantly related to BMD increase at the lumbar spine when lean body mass was considered. As for bone/mineral parameters, BMD increase at the lumbar spine was not significantly related to serum levels of calcium, parathyroid hormone (PTH), and alkaline phosphatase or urinary levels of deoxypiridinoline and calcium excretion. As for BMD parameters, Z-scores of BMD at any site and bone geometry parameters obtained by forearm peripheral quantitative computed tomography were not significantly related to BMD increase at the lumbar spine. BMD increases at the lumbar spine were similar between groups with or without vertebral fractures. In conclusion, BMD increase at the lumbar spine by bisphosphonate treatment was not related to any pretreatment parameters, including body size, body composition, and bone/mineral metabolism in postmenopausal Japanese women with primary osteoporosis, although FPG correlated partly to BMD through lean body mass.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号