井上、井下矿工跟骨定量超声测定分析

目的 通过对井下、井上煤矿工人跟骨定量超声测定进行对比观察，探讨井下工作因缺氧、有机气体、煤尘、潮湿、阳光照射不足等因素对骨代谢的影响。方法 采用UBIS3000型定量超声仪，对200名工人跟骨进行定量超声测定，并将井下、井上测定结果分别进行对比分析，年龄为井下20～48岁。井上为20～54岁。均为男性。结果 井下工作跟骨超声振幅衰减(BUA)，骨刚度(STI)和超声声速(SOS)明显低于井上。结论 井下工作因受环境因素的影响。导致骨代谢的异常，骨吸收增加，提示井下工人及时进行预防治疗，避免骨质疏松的发生，减少骨折发生的因素。     

重庆市区中老年人跟骨定量超声测定分析

目的通过对重庆市区中老年人进行跟骨定量超声测定,分析重庆市区中老年人骨质疏松现状,为该病的防治提供依据和借鉴。方法采用SONOST2000型定量超声仪对855例中老年人右跟骨宽波段超声衰减(BUA)、超声速度(SOS)、骨量指数(BQI)、T值(T-Score)进行检测。结果受检中老年人群骨质疏松发生率约为41．1％,其中女性(58．4％)明显高于男性(33．9％, P<0．01);随着年龄增长,骨质疏松发生率明显增高(P=0．001);女性各项跟骨定量超声测定参数均显著低于老年男性(P<0．01);各项参数随年龄增长而显著减低(BUA:P=0．04,其余P< 0．01)。结论增龄和女性是老年人骨质疏松的重要危险因素,跟骨定量超声检测可以作为骨质疏松人群防治的有效筛选手段。     

跟骨定量超声法评价正常女性骨丢失和骨质疏松患病率

目的　评价正常女性跟骨超声随增龄骨量丢失及骨质疏松患病率。方法　用定量超声法测定了 2 72例正常女性右跟骨宽带超声衰减 (BUA) ,超声声速 (SOS)及骨硬度指数 (STI)。结果女性跟骨峰值骨量出现在 30～ 39岁。 5 0～ 84岁 3组与峰值组以及两两之间比较 ,差异均有显著性(P <0 0 1)。老年组骨质丢失率和骨质疏松患病率分别为 2 6 %～ 37%和 4 2 %～ 6 9%。在各个年龄组中 ,STI丢失率最高 ;STI和BUA骨质疏松检出率相近 ,均大于SOS。结论　跟骨超声的 3项指标均可用于区分绝经前、后的妇女 ;STI检测骨量丢失和OP患病率最敏感     

The relationship between ultrasound and densitometric measurements of bone mass at the calcaneus in women

Summary Broadband ultrasound attenuation (BUA) of the calcaneus predicts axial density in women and is decreased in women who sustain hip fractures. To determine the relationship between ultrasonic and densitometric assessments of bone mass at the same site, BUA and velocity of sound (VOS) were correlated with bone density as measured by dual energy x-ray absorptiometry (DXA) at the calcaneus in 64 Caucasian women aged 35–83 years. BUA, VOS, and bone density in these women decreased annually as a function of age by 1.0%, 0.3%, and 0.9%, respectively. Holding age, years since menopause, height and weight constant, BUA correlated with VOS (r=0.74, P<0.001), and calcaneal density correlated with BUA (r=0.73, P<0.001) and with VOS (r=0.66, P<0.01). The results indicate that both BUA and VOS measurements reflect density at the calcaneus, but suggest that they measure properties of bone other than density and different from each other. The assessment of these additional properties may be useful in the prediction of fracture risk.     

高原藏族居民跟骨定量超声测定分析

[目的]测定生活在海拔3000m高原的藏族居民的跟骨定量超声参数，了解藏族的骨量变化规律和高原环境对其的影响。[方法]采用UBIS3000型定量超声仪，对夏河县596名藏族居民跟骨定量超声参数进行测定。[结果]超声振幅衰减（BUA）、刚度（STI）、超声声速（SOS）的峰值男性为30～39岁，女性为40-49岁，达到峰值后男女性随年龄增长各项指标快速下降，绝经后女性最为明显。[结论]高原藏族居民峰值骨量高，老年后骨量丢失迅速，发生骨质疏松的危险性增加。     

熟地对去卵巢大鼠骨代谢生化指标及骨密度的影响

目的 研究熟地水煎液对去卵巢大鼠骨代谢生化指标及骨密度的影响，探讨熟地对骨质疏松症大鼠的药理作用。方法 采用去卵巢大鼠模型，每天灌胃1g/kg、2g／kg及4g/kg3种剂量的熟地水煎液，3个月后检测大鼠血清雌二醇、骨钙素、碱性磷酸酶、钙、磷、尿脱氧吡啶啉、钙、磷等生化指标及股骨骨密度的变化，并与模型组、正常对照组、己烯雌酚组比较。结果 与假手术组比较，熟地3个剂量组、己烯雌酚组ALP和BGP均明显升高（P〈0．05），E2含量均低于假手术组（P〉0．05）。与模型组比较，各用药组ALP、BGP、尿DPD／Cr、Ca／Cr含量均低于模型组（P〈0．05）。各用药组大鼠股骨骨密度均较模型组有所升高（P〈0．05）。结论 熟地可抑制骨吸收，延缓去卵巢大鼠骨量丢失，对骨质疏松症有一定的防治作用。     

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。     

The effect of ankle oedema on bone ultrasound assessment at the heel

Relatively inexpensive, portable bone ultrasound systems are of particular relevance to disabled or elderly subjects, who may have problems with access to other forms of densitometry. The effects of local soft tissues on ultrasound measurements are poorly understood and, as ankle oedema is common in such subjects, we examined its consequences for bone ultrasound readings at the heel. Eleven elderly subjects (mean age 81 years) with below-knee pitting oedema were assessed using a direct-contact bone ultrasound system (CUBAClinical). We made a total of 16 series of readings, 6 unilateral and 5 bilateral. In each series an initial reading was followed by repeated pressure over the measurement site to disperse oedema; subsequent readings were thus subject to a progressively lessening degree of local oedema, until a steady state was eventually reached in which no further oedema could be displaced. Heel width fell by a mean of 6.3 mm between initial and steady-state readings; consistent with the clinical appearance of moderate oedema, pitting to a mean depth of only 3.15 mm. Measurements in the presence of oedema were compared with those after its elimination, and oedema was shown to cause a mean reduction of 23.9 m/s in velocity of sound (VOS) and of 5.5 dB/MHz in broadband ultrasound attenuation (BUA). Both changes were equivalent to a fall by a quarter of one standard deviation of the reference range, and were significant atp<0.05 on pairedt-test. As the severity of oedema will vary through the day, and from day to day, measurement protocols for bone ultrasound should pay attention to the confounding effects of oedema.     

Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: A population-based case-control study

ObjectiveWe used dual X-ray absorptiometry (DXA) to measure calcaneal bone mineral density (BMD) and estimate the prevalence of osteoporosis in a population with distal forearm fracture and a normative cohort.MethodsPatients 20 to 80 years of age with distal forearm fracture treated at one emergency hospital during two consecutive years were invited to calcaneal BMD measurement; 270 women (81%) and 64 men (73%) participated. A DXA heel scanner estimated BMD (g/cm²) and T-scores. Osteoporosis was defined as T-score ≤? 2.5 SD. Of the fracture cohort, 254 women aged 40–80 years and 27 men aged 60–80 years were compared with population-based control cohorts comprising 171 women in the age groups 50, 60, 70 and 80 years and 75 men in the age groups 60, 70, and 80 years.ResultsIn the fracture population no woman below 40 years or man below 60 years of age had osteoporosis. In women aged 40–80 years the prevalence of osteoporosis in the distal forearm fracture cohort was 34% and in the population-based controls was 25%; the age-adjusted prevalence ratio (PR) was 1.32 (95% CI 1.00–1.76). In the subgroup of women aged 60–80 years the age-adjusted prevalence ratio of osteoporosis was 1.28 (95% CI 0.95–1.71). In men aged 60–80 years the prevalence of osteoporosis in the fracture cohort was 44% and in the population-based controls was 8% (PR 6.31, 95% CI 2.78–14.4). The age-adjusted odds ratio for fracture associated with a 1-SD reduction in calcaneal BMD was in women aged 40–80 years 1.4 (95% CI 1.1–1.8), in the subgroup of women aged 60–80 years 1.2 (95% CI 0.95–1.6), and in men aged 60–80 years 2.6 (95% CI 1.7–4.1). Among those aged 60–80 years the area under the ROC curve was in women 0.56 (95% CI 0.49–0.63) and in men 0.80 (95% CI 0.70–0.80).ConclusionsThe age-adjusted prevalence of osteoporosis based on calcaneal BMD is higher in individuals with distal forearm fracture than in population-based controls. BMD impairment is associated with increased odds ratio for forearm fracture in both women and men but the differences between cases and controls are more pronounced in men than in women, which may have implications in fracture prevention.     

Correlation of ultrasound velocity in the tibial cortex,calcaneal ultrasonography,and bone mineral densitometry of the spine and femur

We compared the attributes of tibial cortex speed of sound (SOS) measurements with the SOS and broadband ultrasound attenuation (BUA) of the calcaneus, and bone mineral densities of the lumbar spine and femoral neck in a patient crossover study. The three instruments used in the crossover study were the LUNAR DPX and Achilles^TM, and a newly introduced device for measuring tibial cortical SOS, the SoundScan^TM 2000. Ultrasound precision determinations on the two instruments were performed with the same group of 10 volunteers, and the bone densitometry precision was derived from 22 patients who were assessed twice in a single visit, with repositioning between spine and hip scans. There were 220 female patients in the clinical study, 28 of whom had thoracic spine fractures, and all had measurements with the three instruments. Of the three instruments, the best precision, or lowest coefficient of variation and standardized coefficient of variation, was obtained with the SoundScan^TM 2000; 0.20% and 1.39%, respectively. The tibial SOS correlated more poorly with the lumbar spine and femoral neck bone mineral densities (BMDs) than the calcaneal parameters in 220 patients. Tibial SOS measurements could not distinguish the group with spinal fracture from an age-matched control group to aP<0.05 level, whereas the lumbar spine BMD and calcaneal BUA and stiffness showed a significant difference. We conclude that the SoundScan^TM 2000 system measures propagation of sound in the tibial cortex with great precision, but its role in clinical practice is moot. Yet to be established by a long-term prospective study is its efficacy in predicting fracture risk and how well it reflects bone change in response to treatment of osteoporosis.     

定量超声与双能骨密度测定在骨质疏松诊断中的应用及评价

目的观察定量超声法(QUS)在骨质疏松诊断中的意义及双能X线骨密度测定法(DEXA)在骨结构评价中的作用.方法采用Osteospace定量超声跟骨测定仪及HologicQDR4500A型双能骨密度测定仪,对40例健康体检者同时测定跟骨超声声速(SOS)、声衰减(BUA)以及全身、正位腰椎、侧位腰椎、侧位腰椎感兴趣区、股骨近端骨密度(BMD).结果BUA、SOS与大多数部位BMD相关关系显著(r=0.35～0.62,P<0.05或P<0.01);股骨近端及正位腰椎2BMD与BUA及SOS的直线回归关系显著(P<0.05).结论QUS是诊断骨质疏松和评价骨强度的良好方法.在DEXA测定部位中,股骨近端及正位腰椎2BMD有较高的评价骨结构特性价值.     

Characteristics of calcaneus quantitative ultrasound normative data in Chinese mainland men and women

Introduction Quantitative ultrasound (QUS) assessment at the calcaneus, as a safe and reliable method for evaluating skeletal status, is rapidly gaining in popularity. Assessment by QUS provides three parameters of skeletal status: broadband ultrasound attenuation (BUA), speed of sound (SOS) and derived data-stiffness index (STI). The objective of the present study was firstly to determine the normative QUS data on healthy Chinese mainland men and women and secondly to investigate the effects of sex, age and body size on these three QUS parameters.Methods A study cohort consisting of 725 healthy Chinese women and 568 men aged 10–83 years participated in this investigation. The three QUS parameters all exhibited a characteristic mild rise-then-fall pattern with increasing age in both sexes. Younger men and women had similar QUS values, while older women had lower values than older men. Age-related differences were more pronounced among females. Pearson’s correlation and regression analysis showed that weight was a major determinant of QUS in both sexes, along with age.Results There were some discrepancies between our data and results from other populations, even when the same type of QUS instrument was used, probably as a result of various factors, including ethnic, life-style environment and diet, among others.Conclusions These normative data will be useful for comparing the results of individual studies, predicting fracture risk of Chinese men and women and determining diagnostic criteria of osteoporosis by QUS.