青海土汉族健康人骨量变化的研究

目的：研究我省土族的骨量变化规律。方法：利用ＳＰＡ法实地检测了该民族的骨量ＢＷ，ＢＭＣ，ＢＭＤ１１０９例，并与西宁地区汉族１１８４例进行了统计学处理和对比发析。结果：汉族老年人ＢＭＤ略高于土族老年人，土族女性ＢＭＤ略高于汉族女性，两民族的ＢＭＤ无显著性差异，结论：首次建立了土族健康人桡，尺骨骨量正常参考值。     

BH 6012型骨密度仪的研制

目的;测定桡骨超远端的骨矿含量（ＢＭＣ）和骨密度（ＢＭＤ）。方法：采用二维扫描,经数据处理系统将通过骨的放射性转换为图像。根据骨图像所显示的形态特征,测定感兴趣区的ＢＭＣ和ＢＭＤ。结果：仪器准确度;ＢＭＣ和ＢＭＤ测定,偏差不超过１．５％。精密度：干桡尺骨标本ＭＢＣ和ＢＭＤ的ＣＶ不超过２％,受试人桡尺骨ＢＭＣ和ＢＭＤ的ＣＶ不超过３％,仪器线性及稳定性良好。测定的２５７例正常人的结果表明：ＢＭＣ和ＢＭ     

纠正飞行人员骨矿质密度偏低综合措施的评价

目的在飞行人员骨矿质密度（ＢＭＤ）调查基础上，采取了防治飞行人员ＢＭＤ偏低的综合措施，并对其进行评估。方法试验组：４７名ＢＭＤ偏低飞行员，男３３人，女１４人，年龄２２－５３岁。经药物、饮食、运动等综合治疗三年余，后再次测定ＢＭＤ及血清三碘甲状腺原氨酸总量（ＴＴ３），降钙素（ＣＴ），骨钙素（ＢＧＰ），雌二醇（Ｅ２）和Ｔ水平，与治疗前及对照组比较。对照组：４８名ＢＭＤ正常飞行员，男３９人，女９人，年龄２３－５１岁。结果ＢＭＤ及血清ＴＴ３、ＣＴ、ＢＧＰ、Ｅ２和Ｔ水平均有明显提高（Ｐ＜０．０１或Ｐ＜０．０５），尤以２０岁年龄组及３０岁年龄组为著。结论在飞行员中采取适宜的防治措施，可提高ＢＭＤ峰值，对防止今后因骨质减少而导致的骨质疏松症可能有重要的意义。     

骨矿含量及血清骨钙素测定对性早熟儿童骨骼发育诊治及疗效考核的价值

为探讨骨矿含量（ＢＭＣ）及骨钙素（ＢＧＰ）测定在性早熟儿童骨骼发育状况的诊断、治疗及疗效考核上的价值，对８２例特发性性早熟女孩，采用单光子吸收法测定桡骨的ＢＭＣ，放射免疫分析法测定血清ＢＧＰ含量。于治疗前及治疗３～４个月后分别测定ＢＭＣ和ＢＧＰ，并与正常同龄儿进行对比。结果：性早熟女孩的ＢＭＣ及血清ＢＧＰ浓度大多较同龄儿显著增高。性早熟Ⅱ～Ⅲ期者ＢＭＣ为０４５２±００８０ｇ／ｃｍ，Ⅳ～Ⅴ期者为０５８５±００９８ｇ／ｃｍ（ｔ＝５３６２，Ｐ＜０００１），示病情越重、病程越长，增高也越明显。治疗后Ⅱ～Ⅲ期者ＢＭＣ降为０３９９±００９３ｇ／ｃｍ，Ⅳ～Ⅴ期者降为０５１９±００７０ｇ／ｃｍ，与治疗前相比，ｔ＝４１４１，Ｐ＜００１。血清ＢＧＰ浓度也均明显降低。表明经过治疗，随着病情缓解，这些指标会有明显改善。因此，ＢＭＣ及ＢＧＰ对性早熟患儿诊治及疗效考核有一定的临床价值。     

高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响

目的：探讨高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响。方法：将大鼠随机分为对照组、脑创伤组和高压氧（ＨＢＯ）组。采用ＢＩＭ－Ⅲ型撞击机撞击大鼠右侧颅顶，复制闭合性颅脑损伤，于伤后２４小时由心脏取血处死，测定脑组织含水率、伊文斯蓝（ＥＢ）含量及脑组织和血浆脂质过氧化物──丙二醛（ＭＤＡ）含量。结果：（１）脑外伤组大鼠右侧脑组织含水率、脑组织及血浆ＭＤＡ含量均显著高于对照组（Ｐ＜０．０１或Ｐ＜０．０５）；右侧脑组织含水率及ＭＤＡ含量显著高于对侧（Ｐ＜０．０１或Ｐ＜０．０５），右侧脑组织ＥＢ含量较对照组升高，但Ｐ＞０．０５；（２）ＨＢＯ组右侧脑组织含水率及脑组织ＭＤＡ含量显著低于脑外伤组（Ｐ＜０．０１或Ｐ＜０．０５），而与对照组及左侧无明显差别；血浆ＭＤＡ、脑ＥＢ含量与对照组、脑外伤组及左侧均无明显差别。结论：ＨＢＯ能减少脑外伤脑组织氧自由基的生成，减轻脑损伤和脑水肿。     

带血管骨膜和同种脱钙骨基质联合移植与自体骨移植修复骨缺损的比较研究

目的了解带血管骨膜（ＶＰ）和同种脱钙骨基质（ＤＢＭ）联合移植替代自体骨移植修复大段骨缺损的可能性。方法以兔桡骨中央２５ｍｍ的大段骨缺损为模型，通过Ｘ线观察、Ｘ线平片骨缺损修复Ｌａｎｅ评分、组织学观察、骨组织形态计量分析和生物力学测试，比较术后４，８，１６周时ＶＰ＋ＤＢＭ联合移植与自体骨移植修复骨缺损的效果。结果术后４周ＶＰ＋ＤＢＭ联合移植及自体骨移植均已较好地完成了缺损的修复，而前者的Ｌａｎｅ评分、皮质骨密度、力学抗扭刚度均显著高于后者（Ｐ＜０．０５）。但术后８，１６周时两者之间已无显著性差异（Ｐ＞０．０５）。结论ＶＰ＋ＤＢＭ联合移植早期修复兔桡骨大段骨缺损的效果好于自体骨移植。后期两种方法修复效果基本一致。ＶＰ＋ＤＢＭ联合移植后，两者之间建立了相互协同、相互促进的关系。     

脱蛋白骨、骨形态发生蛋白和肿瘤坏死因子重组合的人工骨实验研究

在５０只兔的１００个颅骨缺损动物模型中分别植入：（１）牛骨形态发生蛋白（ｂＢＭＰ），牛脱蛋白骨（ｂＤＰＢ）和人重组肿瘤坏死因子α（ｒｈＴＮＦα）；（２）ｂＢＭＰ和ｂＤＰＢ；（３）ｒｈＴＮＦα和ｂＤＰＢ；（４）ｂＤＰＢ。植入后第１、２、４、６、８周行组织学检查及Ｘ线摄片；植入后第１０天、４２天行３５Ｓ和４５Ｃａ液闪计数以及灰重测定。结果显示：三种材料复合物较两种材料复合物成骨更好，而后者又较单一的ｂＤＰＢ成骨好（Ｐ＜０．０１）。全部移植材料均与受体有极好的生物相容性。ＴＮＦα可促进新生血管形成，并能减轻免疫反应及在低浓度情况下有刺激成骨作用。我们认为：载体、骨诱导因子和生长因子的组合是构成具有生物活性人工骨的理想模式，而ＢＭＰ、ＤＰＢ和ＴＮＦα是一种新的有价值的骨移植材料。     

肾上腺髓质素与高血压病关系的初步探讨

目的：探讨肾上腺髓质素（ａｄｒｅｎｏｍｅｄｕｌｌｉｎ,ＡＤＭ）在高血压病中的病理生理作用。方法：观察高血压病患者治疗前、后ＡＤＭ的变化及与血压等的关系。在大鼠离体主动脉血管条上观察ＡＤＭ与血管紧张素Ⅱ（ａｎｇｉｏｔｅｎｓｉｎ　Ⅱ,Ａｎｇ　Ⅱ）释放的相互影响。结果：ＥＨ病人血浆ＡＤＭ水平明显升高,ＡＤＭ与 Ａｎｇ Ⅱ水平、动脉舒张压、动脉平均压（ＭＢＰ）呈显著正相关（相关系数ｒ分别为０．４７１,Ｐ＜０．０１;０．４３５７,Ｐ＜０．０１和０．５５０８,Ｐ＜０．０１）,而与心输出量等无明显相关。使用巯甲丙脯酸和硝苯地平治疗后,ＡＤＭ分别下降约１９．９％（Ｐ＜０．０５）和 １４．５％（Ｐ＞０．０５）,Ａｎｇ Ⅱ下降约 １０．４％（Ｐ＜０．０５）和 １０．０（Ｐ＜０．０５）。药物治疗后,伴随 ＭＢＰ和血浆 Ａｎｇ　Ⅱ降低,ＡＤＭ水平亦有不同程度的下降。Ａｎｇ　Ⅱ增加大鼠离体主动脉血管条ＡＤＭ的分泌,ＡＤＭ则抑制 Ａｎｇ　Ⅱ的释放。结论：血压和 Ａｎｇ　Ⅱ可能与 ＡＤＭ的分泌及／或合成有关,ＥＨ病人血浆 ＡＤＭ水平升高可能是机体的代偿反应。药物治疗后的不同反应与药物的特性有关。     

放射性核素显像在骨缺损修复研究中的应用

用ＳＰＥＣＴ检查骨缺损修复效果。４０只新西兰白兔均于两侧桡骨干造成１５ｃｍ缺损后分成４组，Ａ组植入２５ｍｇ骨形态发生蛋白（ＢＭＰ）与纤维蛋白的复合物；Ｂ组植入２５ｍｇＢＭＰ；Ｃ组单纯植入纤维蛋白；Ｄ组不植入任何材料。术后不同时间进行骨骼显像，同时进行放射学和组织学检查。结果术后１周发现再生性骨盐沉积活动，以Ａ组最为活跃，Ｂ组其次，所揭示规律与组织学和放射学检查结果吻合。因此，ＳＰＥＣＴ和常规检查方法联合应用，可以更早、更全面地评价骨缺损修复的效果。     

骨疏松性骨折的定量CT预测

笔者分析了６３例女性骨疏松病例的脊椎平片及ＱＣＴ检查。６３例中伴骨折者２９例。骨折组的椎骨骨矿密度（ＢＭＤ）明显低于无骨折组者（Ｐ＝０．０００６）。笔者认为，以椎骨ＢＭＤ测值９５ｍｇ／ｃｍ￣３作为骨折阈值更适用于中国老龄妇女。６３例中有异位钙化者１８例。有及无异位钙化组的椎骨ＢＭＤ值有显著性差异（Ｐ＜０．０５），ＢＭＤ值越低，发生异位钙化的机会越大。笔者提议把异位钙化作为判断骨疏松的提示性征象。     

Bone mass of asian adolescents in China: influence of physical activity and smoking

INTRODUCTION/PURPOSE: Research addressing the role of biology and behavior on bone development during times of peak bone acquisition in adolescence is limited. The present investigation was conducted to address the influence of body composition (lean body mass, fat mass), menarche, leisure physical activity, sports team participation, smoking, and second-hand smoke on skeletal mass of a unique sample of Asian adolescents in China. METHODS: A total of 166 girls and 300 boys (ages 12-16 yr) participated in this study. Bone mineral density (BMD) and content (bone mineral content (BMC)) of the forearm and the os calcis were measured using dual energy x-ray absorptiometry (DXA); lean body mass (LBM) and fat mass were estimated by bioelectrical impedance analysis (BIA); grip strength was measured by isometric dynamometry. Menarche, leisure physical activity, sports team participation, and active and passive smoking were determined using questionnaire. RESULTS: In girls, a total of 44% of the variance in forearm BMC was attributed to a model which included LBM (32%), time since menarche (10%), and age (2%); heel BMC was best predicted by LBM alone (42%), with no significant contribution by other variables. In boys, a total of 39% of the variance in forearm BMC was attributed to a model which included LBM (28%), age (5%), sports team participation (4%), height (1%), and fat mass (1%); heel BMC was best predicted by LBM (50%) and height (3%), accounting for 53% of the variance. CONCLUSION: The findings of this study suggest that lean body mass is the primary determinant of bone mass in Chinese adolescents. Menarche is also an important contributor in girls, whereas age and sports team participation are secondary predictors of bone mass in boys.     

青春期女性骨密度变化及相关影响因素分析

目的:分析9～16岁女性骨密度(BMD)值的差异及相关影响因素。方法:随机选取广西省桂林市和广东省广州市714名青春发育期女性(9～16岁) ,采用跟骨超声骨密度仪测量BMD ,采用问卷调查了解对骨密度有影响的生活因素。结果:青春期女性BMD 12岁较9岁高4 4 % ,14岁较12岁高6 . 0 % ,16岁较14岁高2 5 % ;户外活动时间超过6小时/周的女性BMD值高于不足6小时/周者(P <0 . 0 5 ) ;摄入牛奶量≥1杯/天(2 0 0ml/杯)的女性BMD值高于摄入不足1杯/天者(P <0 .0 5 ) ;月经初潮早的女性BMD值比月经初潮晚的女性高(P <0 . 0 5 )。逐步回归分析表明,对青春期女性BMD有影响的因素为月经来潮年限、体重和牛奶摄入量。结论:12～14岁是青春期女性BMD的快速增长期,青春期女性身高增长与BMD增长不同步;月经初潮晚于平均年龄的女性BMD值低;积极参加户外活动对青春期女性BMD积累有一定作用;维持适宜的体重和一定量牛奶的摄入有利于提高青春期女性BMD和达到理想的峰值骨量。     

女子足球运动员与无运动训练女大学生腰椎、股骨颈骨密度比较

目的:探讨足球运动对女性骨密度(BMD)的影响。方法:选择女子足球运动员36例作为实验组,年龄19.56±1.46岁(17～23岁),参加足球运动2年,每年至少参加10个月足球运动。另选在校就读学生33例作为对照组,年龄19.82±1.78岁(17～23岁),2年间仅参加学校规定体育课程的运动。应用双能X线吸收法测量2年实验前后腰椎和股骨颈骨密度。结果:实验组实验后腰椎和股骨颈骨密度较实验前分别上升了2.25%(P>0.05)和4.90%(P<0.05),对照组分别上升0.89%(P>0.05)和2.03%(P>0.05)。与对照组相比,实验组实验后腰椎、股骨颈骨密度显著升高(P<0.05)。结论:长期参与足球运动的年轻女性运动员与无运动训练女性相比可获得更高的骨密度。     

长期木兰拳练习对围绝经期妇女腰椎和股骨近端骨密度及骨代谢相关激素水平的影响

采用双能Ｘ线吸收法（ＤＥＸＡ）、放免测定法对５５名围绝经期妇女进行测试,探讨围绝经期妇女长期进行木兰拳练习对骨密度及骨代谢激素的影响。结果表明,长期进行木兰拳练习的围绝经期妇女的骨密度与久坐工作者相比较;腰椎（Ｌ２－Ｌ４）、股骨颈（ＦＮ）、股骨近端（ＦＴＲＯ）和ＷＡＲＤＳ区（ＦＷＴ）的骨密度有显著性差异（Ｐ＜０．０５;骨代谢相关激素仅甲状旁腺素（ＰＴＨ）有显著性差异（Ｐ＜０．０５＝;同时发现,运动在围绝经期不同阶段的介入对骨密度亦有不同程度的影响。     

Age of menarche in Indian female basketball and volleyball players at different competitive levels.

Data for the age of menarche have been collected on 98 female volleyball players and 75 basketball players. The players belonged to four different levels of competition: international, national, intervarsity and district. Menarche is significantly delayed in players as compared with the controls. There is a continuous trend of increase in the age of menarche with the increasing levels of competition; menarche is more delayed in players playing at a higher level than those at the lower levels of competition.     

济南地区正常成年女性腰椎骨密度检测分析

目的了解济南地区正常成年女性L1~L4各椎体骨密度正常值及变化规律。方法采用双能X线骨密度仪(DEXA)检测399例正常成人女性L1~L4各椎体和平均骨密度值(BMD),按5岁一个年龄组对数据进行整理和统计分析。结果女性各腰椎和平均BMD的峰值出现在35~39岁年龄组,后随年龄增加而逐渐变小,在65~74岁年龄组略有反弹;同年龄组L1~L4各个椎体骨密度值有逐渐加大的趋势,且各椎体均值和变化规律有较大差别。结论获取了济南地区正常成年女性各年龄组腰椎体BMD正常数据及变化特点。     

Bone mineral density in professional female dancers.

OBJECTIVES: To measure the long term effects of dance training and the contribution of the timing and duration of any menstrual disruption on bone mineral density (BMD). DESIGN: Measurement of BMD in 57 premenopausal, previously professionally dance trained women and the relationship to menstrual and training history. MAIN OUTCOME MEASURES: Bone density measurements at lumbar spine and femoral neck by dual energy x-ray absorptiometry. RESULTS: The average Z score for BMD at the lumbar spine in the amenorrhoeic dancers was significantly below that for the normal population. The average Z score for BMD at the femoral neck in the eumenorrhoeic dancers was significantly above that for the normal population. There was a significant difference between the average Z score for BMD at both the lumbar spine and femoral neck between the amenorrhoeic and eumenorrhoeic dancers. Significant negative relationships were found between BMD at the lumbar spine and (1) age at menarche, (2) duration of amenorrhoea, (3) BMD at the femoral neck, and (4) the variable of ideal minus lowest weight, which was independent of amenorrhoea. No significant relationships were found between duration of oral contraceptive pill usage and BMD at either the lumbar spine or the femoral neck in eumenorrhoeic or amenorrhoeic dancers. In order to quantify the effect of a combination of these significant factors, a model of BMD was constructed using multiple regression incorporating the variables duration of amenorrhoea, age at menarche, and ideal minus lowest body weight. In this model R2 was 33.6%, in other words 33.6% of the total variation in the Z score for BMD at the lumbar spine could be accounted for by these factors. CONCLUSION: Professional female dancers with a history of delayed menarche and amenorrhoea have been identified as another group of premenopausal women potentially at risk of developing osteoporosis because of a decrease in BMD at the lumbar spine. The femoral neck in dancers with a history of amenorrhoea was partially protected from loss of BMD by virtue of being the major weight bearing site in previous dance training, and in eumenorrhoeic dancers BMD was significantly increased at this site.     

青春前期和早期女性血清维生素D、雌二醇和瘦体重含量与骨骼发育的相关性研究

目的:研究女性从青春前期到初潮腰椎、股骨颈的发育特征及主要影响因素。方法:201名身体健康的女性(10.9±0.7岁)自愿参加本项实验研究并进行体质测量,主要测量脂肪含量(FM)、瘦体重含量(LM)、以及股骨颈(Fn)和腰椎(Ls)骨密度(BMD)、骨量(BMC)和骨面积(BA)。同时检测血清雌二醇(E2)、类胰岛素样生长因子1(IGF-1)、睾酮(T)和维生素D(VD)等。追踪获得受试者初潮的时间,以此作为时间参考来拟合骨骼的最佳生长曲线。采用stepwise forward多元回归方法来确定腰椎、股骨颈的影响因素。结果:①初潮之前快速增长的股骨颈和腰椎各项指标在初潮之后却出现不同的变化趋势:股骨颈BMD、BMC提高了增长速度;而股骨颈和腰椎BA减慢了增长速度;腰椎BMD、BMC继续保持原有的增长速度。②E2是预测股骨颈BMD和腰椎BMD、BMC增长的重要因子,而VD是预测股骨颈和腰椎BMC、BA变化的重要因素。LM则是预测股骨颈和腰椎BMD、BMC和BA发育的重要因素。结论:女性初潮之前是腰椎、股骨颈的骨面积快速生长时期,而初潮之后则是矿物质积累增长的关键时期。血清维生素D、雌二醇水平与瘦体重含量是女性快速生长时期骨骼发育和矿物质沉积的重要调节因素。     

Bone health and osteoporosis

Good bone health is important to everyone, regardless of age. Osteoporosis is a preventable disease, and steps for increasing bone mass should begin at an early age. To increase bone mass, much of the recent evidence suggests that the best time for intervention with calcium or exercise may be during the prepubertal years. In the older female athlete, BMD is typically well above normal, but even young amenorrheic athletes can have bone density values equal to that of an elderly osteoporotic woman. Myriad treatment options are available for the person with low bone mass, but prevention is a much more preferable alternative.     

Bone mineral density in Hispanic women: role of aerobic capacity, fat-free mass, and adiposity

Understanding the etiology of factors influencing bone mineral density (BMD) in Hispanic women for the prevention of osteoporosis was the aim of this investigation. Whole body BMD (WBBMD) of 39 Hispanic, premenopausal women aged 22 - 51 years was measured using dual-energy X-ray absorptiometry (DXA). Maximal aerobic capacity ((.-)VO(2max)) was determined by treadmill ergometry with direct measurement of oxygen consumption. Fat-free mass (FFM) and fat mass were estimated from two independent techniques, DXA and bioelectrical impedance analysis (BIA). A questionnaire was administered to determine weekly physical activity, age of menarche, oral contraceptive (OC) use, parity, and lactation. Factors with significant correlation to WBBMD were weight ( r = 0.74), body mass index ( r = 0.66), fat mass ( r = 0.68 - 0.69), FFM ( r = 0.55 - 0.65), percent fat ( r = 0.43 - 0.55), sagittal diameter ( r = 0.58), waist circumference ( r = 0.53), hip circumference ( r = 0.66) and weekly activity ( r = 0.40). Stepwise multiple linear regression revealed that 73 % of the variance in WBBMD is attributed to fat mass (55 %), FFM (10 %), and (.-)VO(2max) (8 %). When BIA was used instead of DXA in the regression, (.-)VO(2max) was no longer an independent predictor of WBBMD. Fat mass and FFM accounted for 43 % and 20 % of the variance in WBBMD, respectively, explaining a total of 63 % of the variance. The addition of age, age of menarche, weekly physical activity, OC use, parity, and lactation did not make significant contributions to the variance. The findings of this study suggest that fat mass is a stronger predictor of bone mineral density than fat-free mass to BMD; aerobic capacity is another important predictor of BMD in Hispanic premenopausal women.