东乡族成人低骨量与肌少症相关的肌肉质量下降的相关性研究

目的 分析甘肃省东乡族成人骨量与骨骼肌量变化规律,探讨骨量降低与肌少症相关的肌肉质量下降之间的关系。方法 对甘肃省东乡族432例(男性198例,女性234例)成人骨密度、骨强度及四肢骨骼肌量进行测量及数据分析,不同年龄段多组比较采用单因素方差分析,组间两两比较采用LSD法,相关性分析采用Pearson相关分析。结果 (1)东乡族成年男性骨强度指数及骨骼肌质量指数峰值出现在40～岁、女性出现在20～岁年龄组。(2)东乡族成人不同年龄段均出现低骨量与肌少症相关的肌肉质量下降情况。(3)骨量减少会导致骨强度指数及骨骼肌质量指数降低。(4)骨量异常情况下肌少症相关的肌肉质量下降明显。(5)骨量降低与年龄、骨强度指数、骨骼肌质量指数显著相关。结论 骨量减少与肌少症相关的肌肉质量下降显著相关,骨量异常是肌少症前期发生的一个危险因素。     

跟骨骨折术后功能恢复的相关因素分析

目的:探讨影响跟骨骨折术后功能恢复的相关因素。方法:回顾性分析河北医科大学第三医院2018年1月1日至2020年12月31日收治的符合纳入标准的跟骨骨折患者1 080例,男931例,女149例;年龄平均43.0岁。Sanders分型：Ⅰ型107例,Ⅱ型343例,Ⅲ型471例,Ⅳ型159例。对可能影响术后功能恢复的患者性...     

影响跟骨骨折手术治疗效果的相关因素

跟骨骨折在临床上多见,占全身骨折的1％～2％,约占足部骨折的75％。跟骨骨折中约75％为关节内骨折,这种骨折可引起长期疼痛、功能受损等后遗症,很多患者难以完全恢复健康。跟骨关节内骨折损伤机制和骨折类型复杂,治疗困难,过去大多采取非手术治疗。非手术治疗操作简单,无开放复位带来的手术风险,但由于不易达到解剖整复,     

跟骨骨折外侧延长L形切口并发症非手术相关危险因素分析

目的探讨采用外侧延长L形切口行跟骨骨折切开复位内固定术后切口并发症的非手术相关危险因素。方法回顾分析2006年9月-2011年8月58例63足经外侧延长L形切口行切开复位内固定的闭合性跟骨骨折患者临床资料。男52例56足,女6例7足;年龄18～64岁,平均35岁。致伤原因:坠落伤53例58足,交通事故伤5例5足。伤后至手术时间3～22 d,平均8 d。骨折根据Sanders分型标准分型:Ⅱ型4足,Ⅲ型31足,Ⅳ型28足。观察术后切口并发症发生情况并分级,其中分级≥2级列入并发症组,<2级列入对照组。对可能导致切口并发症的18个变量进行单因素分析,对差异有统计学意义的变量进行多因素非条件logistic回归分析。结果 41例46足切口Ⅰ期愈合,纳入对照组;17例17足出现2级及以上切口并发症,纳入并发症组。其中皮肤坏死、红肿或裂开14例,浅表感染3例,均经对症处理后愈合。单因素分析显示,脊柱骨折、糖尿病及吸烟史3个变量差异有统计学意义(P<0.05);多因素分析显示,脊柱骨折为独立危险因素(95%可信区间:0.004～0.360,P=0.004)。结论合并脊柱骨折是采用外侧延长L形切口行跟骨骨折切开复位内固定术后发生切口并发症的独立危险因素。     

跟骨钢板治疗跟骨粉碎性骨折的疗效分析

目的 探讨跟骨钢板治疗跟骨粉碎性骨折的效果.方法 对57例跟骨粉碎性骨折采用跟骨钢板内固定.术后进行疗效评定,并对治疗前后的B6hler角和Gissane角变化和并发症进行观察.结果 Sanders Ⅱ型、Ⅲ型、Ⅳ型骨折优良率分别为92.00%;77.78%,63.64%.治疗后,B6hler角和Gissane角得到恢复,与治疗前比较统计有意义(P<0.05).结论 采用跟骨钢板治疗跟骨粉碎性骨折,对Sanders Ⅱ型骨折的效果最佳,并能恢复B6hler角和Gissane角,是值得推荐的一种治疗方法.     

跟骨骨折切开复位内固定影响疗效的因素

目的探讨影响跟骨骨折切开复位内固定术的疗效及影响疗效的因素。方法切开复位内固定治疗135例跟骨骨折患者,对影响手术疗效的因素进行统计学分析。结果 135例患者获得随访,时间6~12个月。骨折Sanders分类优良率:Ⅱ型83.8%,Ⅲ型骨折76.9%,Ⅳ型骨折51.5%,P0.05;合并糖尿病优良率:有糖尿病68.4%,无糖尿病82.5%,P0.05;吸烟史优良率:有吸烟史53.1%,无吸烟史78.6%,P0.05;固定方式优良率:斯氏针固定53.6%,跟骨钢板75.9%,跟骨锁定钢板固定82.1%,P0.05;复位质量优良率:解剖复位76.9%,非解剖复位58.1%,P0.05。结论切开复位内固定术治疗跟骨骨折手术疗效好,骨折Sanders分类、骨折固定方式以及骨折复位情况为影响跟骨骨折患者预后的独立危险因素。     

术后跟骨螺钉取出的影响因素分析

目的:探讨术后跟骨螺钉取出的相关影响因素。方法:回顾性分析2015 年1 月—2016 年12 月在天津市天津医院进行各种足踝手术需要跟骨螺钉固定的患者118 例,其中男61 例,女57 例。平均年龄(53.0±7.0)岁,平均体质指数(26.0±5.0)kg/m2。比较不同临床特征患者的螺钉取出情况,将本组患者分为小螺钉组(螺钉长度≤ 6.5 mm)58 例,大螺钉组(螺钉长度＞ 6.5 mm)60 例,比较两组的螺钉取出比例。结果:随访2 年,共取出14 个螺钉,其中炎性关节炎的螺钉取出率达37.5%(3/8),高于无炎性关节炎者的10.0%(11/110),差异有统计学意义(χ2=4.645,P <0.05)。大、小螺钉组患者的螺钉取出比例(13.8% vs 11.7%),差异无统计学意义(χ2=1.572,P >0.05)。结论:对于患有炎性关节炎的患者,应谨慎使用跟骨螺钉。使用较小直径的跟骨螺钉可能更能降低由于足跟疼痛导致的螺钉取出率。     

外侧延长“L”形切口治疗跟骨骨折常见并发症及相关因素分析

[目的]探究跟骨骨折外侧延长"L"形切口内固定手术的常见并发症,分析相关因素。[方法]对本院行跟骨骨折外侧延长"L"形切口内固定手术的78例患者临床信息进行回顾分析,将术后并发症等级≥2记为观察组,<2记为对照组,分析并发症危险因素。[结果]单因素分析显示,患者术后并发症的发生与年龄≥65岁、长期吸烟史、糖尿病史、受伤至手术时间<7 d、未采用"不接触"技术保护软组织、术后未放置引流管相关(P<0.05);经Logistic回归分析,年龄≥65岁、长期吸烟史、糖尿病史、受伤至手术时间<7 d、未采用"不接触"技术保护软组织、术后未放置引流管是跟骨骨折外侧延长L形切口内固定手术后发生并发症的危险因素。[结论]对于跟骨骨折外侧"L"形切口内固定术患者,应当选择合适的手术时机,手术中注意保护软组织,术后放置引流管,同时嘱恢复期的患者戒烟,规律治疗糖尿病,以防止并发症的发生。     

移位跟骨骨折--不良结果的预后因素

A MEDLINE search was performed to identify studies published from January 1999 to March 2004 examining-prognostic factors following displaced intraarticular cal-canealfractures(DIACF). From a list of 5articles identified from the search strategy, three re…     

跟骨外侧延长L形切口并发症的危险因素分析

目的 :探讨跟骨外侧延长"L"形切口治疗闭合性跟骨骨折术后发生切口并发症的相关危险因素,明确降低切口并发症的有效干预手段。方法:回顾性分析2011年1月至2015年1月收治的285例(315足)行跟骨外侧延长"L"形切口治疗闭合性跟骨骨折患者的临床资料,对可能影响术后切口并发症的18个临床相关危险因素进行单因素分析,对存在统计差异的变量再给予多因素Logistic回归分析。结果:285例(315足)共有29例(30足)出现切口并发症,其中切口皮缘红肿渗出、不愈合9足,皮缘发黑坏死或者切口裂开16足,皮肤软组织浅层感染3足,骨髓炎2足。单因素分析结果显示:坠落高度(P=0.017)、糖尿病病史(P=0.026)、吸烟史(P=0.001)、手术时间(P=0.003)4个因素差异有统计学意义,将这些因素再进行多因素Logistic回归分析,发现糖尿病(P=0.029)、吸烟史(P0.001)、手术时间(P=0.018)是跟骨外侧延长"L"形切口术后并发症的危险因素。结论 :术前戒烟、积极控制血糖以及熟悉手术操作,有效减短手术时间可以减少跟骨外侧延长"L"形切口并发症的发生率。     

成人隐匿性自身免疫性糖尿病患者骨密度变化及影响因素分析

目的探讨成人隐匿性自身免疫性糖尿病(latent autoimmune diabetes in adults,LADA)患者骨密度(bone mineral density,BMD)变化及其影响因素。方法选取2013年4月至2016年6月于武警浙江总队杭州医院内分泌科确诊的LADA患者43例,作为LADA组,另选同期健康体检人员40名作为对照组。检测两组受试者代谢指标空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血钙、血磷、24 h尿钙、24 h尿磷、碱性磷酸酶(alkaline phosphatase,ALP)、尿微量蛋白(microalbuminuria,MAU)水平,并检测腰椎2~4BMD及股骨颈BMD进行比较。同时研究L2~4BMD及股骨颈BMD与代谢指标水平之间的关系,并分析L2~4BMD及股骨颈BMD的影响因素。结果两组受检者血磷、24 h尿磷、ALP水平均无明显差异(P0.05),LADA组FPG、2hPBG、HbA1c、24h尿钙及MAU均明显高于对照组(P0.05),LADA组血钙明显低于对照组(P0.05);LADA组L2~4、股骨颈BMD均明显低于对照组(P0.05);L2~4BMD与HbA1c、MAU呈负相关(r=-0.351、-0.242,P0.05),与血钙呈正相关(r=0.396,P0.05);股骨颈BMD与HbA1c、MAU呈负相关(r=-0.462、-0.118,P0.05),与血钙呈正相关(r=0.411,P0.05)。结论LADA患者的骨密度明显低于健康受试者,性别、血钙、MAU为L2~4BMD的影响因素,年龄、性别、血钙、MAU为股骨颈BMD的影响因素。     

兰州汉族青少年骨强度指数特点及其影响因素分析

目的调查分析兰州汉族青少年跟骨骨强度指数(bone strength index,SI)变化规律,探讨其影响因素。方法采用超声骨密度仪和生物电阻抗分析仪测量662例(男345例,女317例)兰州汉族青少年SI及体重、体质量指数(body mass index,BMI)、去脂体重、脂肪量4项体成分指标,采用Pearson相关分析法和多元逐步回归法探讨SI的影响因素。结果总体来看,随年龄增加,兰州汉族青少年SI以及身高、体重、BMI、去脂体重、脂肪量5项指标均呈上升趋势。但是,不同性别以及不同年龄段各指标的增长速度存在差异,一般在17岁组或18岁组达到峰值,其中14岁左右为骨发育速度高峰。SI仅在总体上和13岁组存在性别差异且女性大于男性。SI与性别、年龄、身高、体重、BMI、去脂体重、脂肪量均呈正相关关系。而性别、年龄和BMI是SI的主要影响因素。结论兰州汉族青少年SI在不同性别和不同年龄段间变化规律不同,主要的影响因素为性别、年龄及BMI。     

长春市24831例前臂远端骨密度影响因素研究

目的研究年龄、性别、体重指数(BMI)、饮食、运动、吸烟、嗜酒、慢性胃炎、糖尿病、高血压、甲状腺机能亢进、父亲骨折病史、母亲骨折病史及女性生育、绝经等因素对骨密度(BMD)的影响。方法双能X线骨密度仪(pDXA)检测前臂远端BMD,用自制的问卷调查表记录受试者生活习惯、慢性病史及女性绝经、生育史等进行统计学分析。结果年龄、性别、体重、运动、饮食、吸烟、嗜酒、慢性胃炎、高血压病、甲状腺机能亢进及母亲骨折病史与BMD检测值相关,具有统计学意义;而父亲骨折病史、Ⅱ型糖尿病病史与BMD无关,女性绝经年限和生育次数与BMD呈明显负相关。结论吸烟、嗜酒、母亲骨折病史、慢性胃炎、甲状腺机能亢进、高血压病史及女性绝经、生育次数是OP的危险因素。运动、喝牛奶、吃海产品、体重指数是OP的可控因素。     

广西巴马476名健康成年男性跟骨超声骨密度分析

目的 检测广西巴马地区健康成年男性的骨密度,探讨其骨密度随年龄、身高、体重和BMI变化的规律。方法 采用韩国生产跟骨超声骨密度测定仪对广西巴马地区随机抽取的476名20～111岁健康成年男性进行跟骨SI测量。按不同年龄分组,每组10岁,80岁以上合并为1组,共7组,对所测量的数据通过SPSS16.0进行分析。结果 男性跟骨SI峰值骨密度在20～30岁年龄段,SI随着年龄的增加出现下降的趋势。男性骨质疏松症的患病率随年龄的增加而逐步升高。偏相关性分析显示,男性SI与年龄呈现负相关（r=-0.219,P＜0.05）与体重有显著（r=0.167,P＜0.05）关系,但未发现与身高和BMI有线性关系。结论 广西巴马地区20～111岁健康成年男性SI与年龄和体重有显著相关性,本研究获得的SI将为该地区男性骨密度的参考值和骨质疏松症的临床诊断提供参考依据。     

Ultrasound bone densitometry of the calcaneus in healthy Chinese children and adolescents

Introduction We evaluate reference data to examine whether there are sex-, age-, height-, weight- and BMI-related differences of quantitative ultrasound parameters (QUS) for healthy Chinese children and adolescents. Methods A total of 726 healthy children and adolescents (360 male and 366 female) aged from 10–21 years were examined with a Lunar Achilles Express densitometer. The measurements on the right heel included speed of sound (SOS), broadband ultrasound attenuation (BUA), and a calculated stiffness index (SI). Results Our results found that there were no significant differences for BUA, SOS and SI between males and females, except in the age range of 12 to 13 years. The values of all parameters were significantly higher in the 12-year-old females compared to males, and BUA values were significantly higher in 13-year-old females compared to males. A spurt in QUS parameters were observed at 12 years in females and at 14 years in males. A steady increase of BUA, SOS, and SI was seen with increasing body height and weight in both sexes. Conclusion In conclusion, the present results can be used as reference data for children and adolescents in China.     

Assessment of the relationship between broadband ultrasound attenuation and bone mineral density at the calcaneus using BUA imaging and DXA

The purposes of this study was to determine the relationship between broadband ultrasound attenuation (BUA) and bone mineral density (BMD) measured at different regions of the calcaneus with identical site-matched regions of interest (ROIs). Dual-energy X-ray absorptiometry (DXA) measurements of the calcaneus and BUA imaging were performed in 30 women (15 premenopausal and 15 postmenopausal). Four square ROIs were located in the great tuberosity and one square ROI in the foramen calcaneus. A ROI adapted to the shape and size of the whole calcaneus was also considered. All ROIs were analyzed three times with both techniques to minimize intra-observer variability. The correlation coefficient between attenuation and frequency was used as an index of BUA measurement error. Before accepting a measurement of BUA in inhomogeneous material, it could be useful to map the spatial variations of the measurement error. In all ROIs we found the BUA and BMD were strongly related (r=0.78–0.91,p<0.001). The correlation between BUA and BMD was slightly higher in the inferior part of the posterior tuberosity than in the superior part and in the foramen calcaneus. The very high correlation between attenuation and frequency found in all ROIs (r=0.99) suggests that measurement errors of propagation were probably not significant. Ultrasound imaging yields the opportunity for studying the spatial acoustic properties in the calcaneus and their relation to bone mass or structural parameters provided by independent imaging techniques. BUA measured with current transmission techniques reflects mainly bone mass, and microarchitecture to a smaller extent.     

甘肃省兰州地区中老年女性骨密度现状调查及危险因素分析

目的调查研究甘肃省兰州地区中老年女性的骨密度情况,并分析体重指数与骨质疏松的相关性。方法选取2019年5月1日至2019年10月30日期间于甘肃省妇幼保健院行健康体检的女性。详细记录其年龄、绝经状态、身高及体重,采用双能X线吸收骨密度仪进行检测。结果共纳入2 078名研究对象。其中绝经前组204名,占9.82%,平均年龄(41.10±3.19)岁;围绝经期组443名,占21.32%,平均年龄(49.29±2.18)岁;绝经后组1 431名,占68.86%,平均年龄(56.25±7.59)岁。围绝经期组及绝经后组平均绝经年龄分别为(50.43±1.30)岁、(48.42±3.06)岁。三组平均身高、体重及体重指数分别为(1.59±0.05) m、(59.58±7.78) kg及(23.71±3.11) kg/m2。左侧股骨颈的平均骨密度分别为:绝经前组(0.85±0.14) g/cm2、围绝经期组(0.91±0.15) g/cm2、绝经后组(0.82±0.12) g/cm2;左侧全部髋关节的平均骨密度分别为:绝经前组(0.99±0.16)g/cm2、围绝经期组(0.97±0.17) g/cm2、绝经后组(0.88±0.13) g/cm2。腰1～4全部椎体的平均骨密度分别为:绝经前组(1.13±0.22) g/cm2、围绝经期组(1.10±0.20) g/cm2、绝经后组(0.97±0.15) g/cm2。所有绝经前女性的骨密度均正常;围绝经期女性中,正常骨密度占45.15%,骨量减少占32.28%,骨质疏松占22.57%;绝经后女性中,正常骨密度占19.57%,骨量减少占33.54%,骨质疏松占46.89%。Spearman等级相关分析结果示BMI与骨质疏松的发病率呈正向显著相关。结论甘肃省兰州地区中老年女性的骨质疏松发病率随年龄的增长而明显增高,尤其是绝经后及肥胖者,定期监测骨密度成为其不可或缺的体检项目。     

Ultrasound and dual X-ray absorptiometry measurement of the calcaneus: Influence of region of interest location

Ultrasound measurements of the calcaneus are related to incidence of osteoporotic fracture. Such measurements are generally made at fixed coordinates relative to a footplate. This study compares measurements at an anatomically located region of interest (ROI_anat) and at fixed coordinates (ROI_fixed), with bone mineral density measurements, in 84 postmenopausal women. Bone mineral density (BMD) was assessed using dual energy X-ray absorptiometry at both ROIs as well as at lumbar spine and femoral neck. Broadband ultrasound attenuation and velocity of sound were measured using a CUBA system at ROI_anat and ROI_fixed. Additionally, broadband ultrasound attenuation at ROI_fixed was measured using a Walker Sonix instrument. Mean bone mineral density, broadband ultrasound attenuation and velocity of sound did not differ significantly between ROI_fixed and ROI_anat, although broadband ultrasound attenuation by Walker Sonix (81.4±14.6 dBMHz^-1) was significantly (P<0.001) greater than that by CUBA (63.7±14.2 dBMHz^-1). The relationship between broadband ultrasound attenuation and BMD differed significantly between the 2 ROIs and the correlation of this relationship was significantly greater at ROI_fixed than at ROI_anat (r=0.74 versus 0.46, P<0.01). The differing relationship may reflect structural variation at different regions. ROI selection may thus be a possible confounding factor in ultrasound measurement.     

Lifestyle factors affecting bone ultrasonometry of the calcaneus in Japanese women

Ultrasonometry is increasingly used to assess bone characteristics. A group of 1412 women with a mean age of 57 years attended a screening examination in a Japanese city. Seventy-four percent of participants were postmenopausal. Broadband ultrasound attenuation (BUA), speed of sound (SOS), and Stiffness index (SI) of the calcaneus were measured; subjects also completed a questionnaire examining lifestyle factors; anthropometric data were recorded. Analysis showed that the strongest predictors of decreased BUA, SOS, and SI were increased age and menopausal status. Higher body mass index and current participation in exercise or sports were significant predictors of increased BUA, SOS, and SI in a multivariate model. Higher calcium intake predicted increased BUA (P= 0.004) and missing meals predicted a lower SOS (P= 0.019). This study suggests that dietary factors as well as physical activity influence bone characteristics assessed by QUS. QUS may be a suitable technique to assess the effect of lifestyle changes on bone. Received: 29 December 1998 / Accepted: 26 July 1999