广西百色地区苗族健康女性骨密度及骨质疏松患病率的研究

目的了解广西百色地区苗族健康女性骨峰值(PBM)和骨质疏松(OP)的发病情况。方法选取苗族健康女性506名采用单光子二维骨密度仪检测左侧桡骨、尺骨超远端的骨密度(BMD)值,按年龄进行分组,以5岁作为1个年龄段。结果①百色地区苗族女性骨峰值年龄在40岁以上至45岁。②苗族桡骨、尺骨PBM值(g/cm2)分别为0.3347±0.0490、0.3340±0.0585。③60岁后OP患病率为25.23%。结论应用二维骨密度超远端测定,获得百色地区苗族正常女性PBM,对骨质松症的诊治具有重要意义。老年人有较高的骨质疏松检出率,他们是骨质疏松性骨折的高危人群。     

广西百色地区壮族和汉族健康女性骨密度的研究

目的　了解百色地区骨峰值 (PBM)的基本情况 ,为骨质疏松 (OP)的诊断及防治效果评估提供依据。方法　选取健康女性 838名 (壮族 4 15 ,汉族 4 2 3) ,进行二维骨密度测定 ,检测左侧桡骨、尺骨超远端的骨密度 (BMD)值。按民族、年龄进行分组 ,以 5岁作为 1个年龄段。结果　①百色地区女性骨峰值年龄均在 4 0～岁。②壮族桡骨、尺骨PBM值 (g/cm2 )分别为0 35 35± 0 0 4 6 2、0 3384± 0 0 6 6 0。③汉族桡骨、尺骨PBM值 (g/cm2 )分别为 0 3433± 0 0 6 81、0 330 4± 0 0 5 97。④壮汉族间PBM值差异无显著 (P >0 0 5 )。结论　应用二维骨密度超远端测定 ,获得百色地区壮汉族正常人群PBM ,对骨质疏松症的诊治都具有重要意义。壮汉族间PBM值差异无显著。     

大连汉族成年男性腰椎骨密度CT定量研究

目的探索健康成年男性骨密度及其峰值变化规律,为骨质疏松症的防治提供科学依据,同时为建立中国北方成人的正常骨密度值数据库积累数据。方法采用定量CT技术和骨密度专用分析软件测量分析腰椎L1-L5椎体骨密度。结果大连地区成人腰椎骨密度平均值(197.27±23.71)mg/ml、峰值(212.60±7.08)mg/ml,诊断骨质疏松症的正常参考值(212.60±59.26)mg/ml;平均峰值出现在24-32岁,之后骨密度随年龄逐渐缓慢下降,48-50岁骨量丢失显著;其中L4椎体在20-59岁的各年龄段的骨量变化均有显著性差异,比其他腰椎更具有年龄敏感性。结论大连地区汉族男性成人应从48岁关注预防骨质疏松症。     

Association of the CT gene (CA) polymorphism with BMD in osteoporotic Mexican women

Calcitonin (CT) plays a role in the pathogenesis of osteoporosis and genetic variations in or adjacent to the CT gene may be associated with loss of bone mineral density (BMD). The correlation between a dinucleotide (cytosine-adenine) repeat polymorphism at the CT locus and BMD was examined in 70 osteoporotic women, 70 non-osteoporotic women and 500 subjects from the Mexican population. The allele A and genotype AA frequencies were significantly higher in osteoporotic women than in non-osteoporotic women (60% vs 32%; p < 0.0001 and 41% vs 14%; p = 0.0007, respectively). Genotype AA was associated with the presence of osteoporosis [odds ratio 2.58; 95% confidence interval (CI); 1.62-4.12]. Likewise, the loss of lumbar BMD and T scores were related to the presence of allele A: subjects with a single A allele displayed lower values for lumbar BMD and T score (84.02% and -1.51, respectively) than those who do not present any A allele (89.61% and -0.88, respectively). Individuals with two alleles A showed the lowest lumbar BMD and T-score values (73.77% and -2.51, respectively). Analysis of potential confounder demonstrated that aging has a significant effect on osteoporosis development (odds ratio 1.1; 95% CI; 1.1052-1.152).     

广西壮族自治区壮、汉族健康人群跟骨超声骨密度的比较

目的获得广西壮族自治区壮、汉族各年龄组跟骨超声骨密度的正常值范围,比较分析壮、汉族骨峰值与骨质疏松患病率之间的差异,为该地区骨质疏松的诊断和预防提供科学依据。方法采用美国Lunar公司的Ach illesExpress跟骨超声骨密度测定仪,对广西壮族自治区1 646例(壮族男/女:350/441,汉族男/女:357/498)11~61岁健康志愿者进行跟骨超声硬度指数(SI)测定。按不同民族、性别、年龄进行分组,每10岁为一个年龄组,男、女各分5组,对数据进行统计分析。结果壮、汉族男、女跟骨超声骨密度呈现相似的变化规律,各年龄组骨密度均未见显著差异。男、女跟骨SI均在21~30岁年龄组达到峰值,之后均开始下降。壮、汉族男、女各年龄组骨质疏松患病率无显著差异。结论使用定量超声技术获得广西壮族自治区壮、汉族男、女健康人群跟骨SI值参考值范围,对骨质疏松的诊治具有重要意义。壮、汉族男、女峰值骨密度水平及骨质疏松患病率均无显著差异。     

Effects of alendronate and hormone replacement therapy, alone or in combination, on bone mass in postmenopausal women with osteoporosis: a prospective, randomized study

The effectiveness of hormone replacement therapy (HRT) and alendronate, alone and in combination, was evaluated in 120 postmenopausal patients with osteoporosis with bone mineral density (BMD) measurements at least 2 SD below the mean value for young premenopausal subjects. They had no contra-indications to HRT or alendronate use and were randomized to three different treatment groups. Group I was treated with micronized 17 beta-oestradiol 2 mg and norethisterone acetate 1 mg/day per os, group II received alendronate 10 mg/day per os and group III received micronized 17 beta-oestradiol 2 mg, norethisterone acetate 1 mg/day per os and alendronate 10 mg/day per os for 1 year. Elementary calcium 1500 mg/day was supplied to patients in all three groups. Spinal and femoral neck BMD and markers of bone mineral metabolism were measured on each patient before treatment and 6 and 12 months after treatment in 95 patients. At the end of the 12th month, significant increases in spinal and femoral neck BMD were found in all groups. Increases in spinal BMD were significantly higher in patients treated with alendronate and alendronate with HRT when compared with patients treated with HRT only. No significant difference was found in femoral neck BMD changes between the groups. Significant decreases in bone resorption and markers of bone formation were observed in all groups. Alendronate was found to be more effective than HRT and could have a very beneficial effect when added to the HRT regimen in patients with postmenopausal osteoporosis. Alendronate might also be used in postmenopausal patients with osteoporosis when HRT is contra-indicated or when there is reluctance to use hormonal treatment.     

小剂量雌二醇和孕酮对绝经后妇女骨质疏松的疗效研究

目的 :研究小剂量雌二醇和孕酮对绝经后妇女骨质疏松的影响 ,以评估其疗效。方法 :将 6 8例绝经3年以上 ,年龄 (5 2 5 9)岁 ,平均 5 6岁 ,体重指数不超过 2 5 ,经GBD— 92 8单光子骨矿物质密度测定仪测量前臂尺、桡骨远端 1 / 3处的骨矿物质密度 (BMD)的水平 ,诊断为骨质疏松的妇女 ,分成两个组进行治疗。第一组 36例为对照组 ,每天仅用乐力 2 0 0 0mg ,第二组 32例为治疗组 ,每天除用乐力 2 0 0 0mg外 ,加用 1 7βE2 0 5mg和醋酸甲羟孕酮 (MPA) 0 5mg。在治疗前、后 ,所有受试者均经BMD、妇检、阴道B超、阴道细胞学和乳房红外线检查。结果 :所有受试者在治疗前BMD的水平 ( x±s,g/cm2 )为 0 4 6± 0 0 7;治疗 1年后 ,对照组 :0 4 9± 0 0 5 ,均值比治疗前升高 3% ;治疗组 :0 5 2± 0 0 6 ,均值比治疗前升高 6 % ;治疗组中 ,有 1 0例患者在治疗前有轻度乳腺小叶增生 ,9例有 <1cm2 子宫肌瘤 ,在给予 1 7βE2 、MPA和钙剂治疗的同时 ,给予中成药平消胶囊和舒肝散进行治疗。 1年后 ,乳腺小叶增生者有 6例好转 ,4例不变。子宫小肌瘤者 4例略有缩小 ,5例不变。其余所有对象治疗 1年后 ,各项检查均未见异常。结论 :本文结果表明 ,仅用钙剂治疗绝经后妇女骨质疏松的疗效较差 ,钙剂加小剂量 1 7βE2 和M     

糖尿病相关骨转换指标研究进展

骨质疏松症是糖尿病常见并发症之一,也是影响糖尿病患者生存质量及寿命的主要原因.骨密度(bone mineral density,BMD)测定是早期诊断骨质疏松的标准,然而,一些BMD正常的潜在骨质疏松患者易被忽略.因此,寻找敏感性和特异性更高的骨代谢标志物来预测早期骨代谢异常具有重要意义.     

广西毛南族健康女性定量超声骨量峰值

目的:建立毛南族女性定量超声骨量峰值,为骨质疏松症的诊断和防治效果的评估提供依据。方法:用定量超声骨密度仪对533名毛南族健康女性进行骨定量超声测定和分析。测量身高、体质量、足长和左侧跟骨超声振幅衰减(BUA)。结果:毛南族女性年龄在40~45岁时BUA峰值(64·34±7·87)db/MHz。25~40岁各组平均体质量随年龄增大而增高,40~45岁达最高值,随后逐渐下降。结论:用定量超声骨密度仪测定跟骨,获得毛南族女性定量超声BUA峰值,对毛南族女性骨质疏松症的诊断和治疗具有重要意义。     

甲状旁腺素和二膦酸盐对骨密度和骨生物力学的影响

目的:研究应用甲状旁腺素和阿仑膦酸钠对激素性骨质疏松兔骨密度和生物力学的影响。方法:采用成年新西兰大白兔,随机分为对照组、激素模型组、甲状旁腺素和阿仑膦酸钠治疗组,9周后取股骨和腰椎行超声骨密度测量,再行股骨扭转、三点弯曲和腰椎压缩试验。结果:激素模型组的宽频超声衰减(BUA)、超声传导速度(SOS)值和骨生物力学参数较对照组有非常明显减少,甲状旁腺素和阿仑膦酸钠治疗组的BUA、SOS值和骨生物力学参数较激素模型组明显增加。结论:序贯应用甲状旁腺素和阿仑膦酸钠可以减少激素性兔骨量的丢失,预防骨质疏松的发生。     

老年人骨质疏松运动预防策略研究进展

随着我国老龄化程度的加剧,骨质疏松的发病率正在急剧上升。运动疗法作为骨质疏松的三大治疗和预防手段之一,以其可靠、方便、安全、廉价等特点正在受到越来越多的重视和推广。同时,运动疗法还具有增强老年人肌肉力量、提高平衡能力、改善生活质量等特点,因此正在成为预防骨质疏松的最主要方法。从有氧运动、抗阻运动和振动运动等3个方面系统综述目前运动疗法中普遍使用的方法、效果及其特点,并进行对比和分析;同时本文对运动预防策略中使用的强度与频率进行讨论与总结;最后指出骨质疏松运动预防目前存在的亟需解决的问题,有助于读者进一步深入开展研究。