昆明玉溪市7~20岁超声及单光子骨密度调查分析

目的了解玉溪市7～20岁在校学生定量超声(QUS)及单光子(SPA)骨密度(BMD)状况,为建立相应群体超声骨密度及单光子骨密度正常参考范围提供数据源并比较二者异同。方法选择7～20岁玉溪市范围内正常学生1020例为检测对象,用定量超声骨密度仪及单光子骨密度仪测定受检者足跟部及前臂桡骨骨密度值。结果 7～20岁QUS及SPA BMD检测结果线性相关(女生:F=0.9507,P<0.05;男生:F=0.9672,P<0.05)。7～12岁学生QUS及SPA BMD在男女之间,上下一岁之间无统计学差异,男生BMD稍高于女生,但这种差别不具统计学意义(P>0.05),二者均呈匀速缓慢增加态势。12～13岁时,女生因月经来潮,BMD有一个快速增长期,并反超男生。14～16岁时,男女生QUS及SPA BMD呈缓慢上升态势,女生QUS BMD甚至在14岁时出现负增长。16岁后女生BMD随着雌激素的快速增加而增高,但与男生相比未及男生增高迅速,男生SPA及QUS BMD分别于17岁及18岁时超过女生。结论 7～20岁学生QUS及SPA法测定的BMD具有极显著相关性(P<0.01),证明超声骨密度完全可以替代传统的单光子骨密度,适用于基层医院及下乡骨密度普查。两种方法测定骨密度的整体水平有显著性差异(P<0.05),故诊断骨质疏松参考标准不能混用及结果也无法进行比较。由于12～13岁、16岁时女生较其他年龄组有显著性差异(P<0.05),两种方法均需单独建立该年龄段参考标准,其余年龄段则可根据各地调查面大小,做适当组别合并以减少T值计算负担,提高工作效率。

Investigation and analysis of bone mineral density measured by QUS and SPA in 7~20 years old people in Yuxi

Objective To investigate bone mineral density(BMD) of school students measured by QUS and SPA,and to establish the normal BMD range from the measurements and to compare the data between the two sources.Methods One thousand and twenty students aged from 7 to 20 years old were selected as subjects.BMD of the calcaneus or the radius were measured with QUS or SPA.Results BMD of 7～20 years old students measured by QUS and SPA was linearly correlated(girls: F=0.9507,P<0.05;boys: F=0.9672,P<0.05).In 7～12-year-old group,the difference of BMD between QUS and SPA result and between 1-year age intervals were not statistically significant.BMD of boys was slightly higher than that of girls,but the difference was not statistically significant(P>0.05).BMD in both genders increased gradually.In age of 12～13,BMD in girls increased rapidly due to initiation of menses,and it overrun that in boys.In age of 14～16,BMD of both genders increased slowly in terms of QUS and SPA results.BMD by QUS showed negatively increase in girls of age 14.BMD increased rapidly in girls since 16 years old due to the fast increase of estrogen level,but the increase did not exceed that of boys.BMD measured by both QUS and SPA in boys exceeded that in girls at ages of 17 and 18.Conclusion BMD measured by QUS and SPA correlates significantly in students aged 7～20(P<0.01),indicating that QUS can overtake SPA for the measurement of BMD,and it is suitable for BMD screening in rural hospitals.The level of BMD measured by two methods is significantly different(P<0.05),therefore the diagnosis standard of osteoporosis can not be confused and the results can not be compared.Because of the significant difference of BMD in girls of age 12～13 and 16,the reference standard by the two methods should be established independently.BMD in students of other ages can be combined according to investigation range in different regions,in order to decrease the burden of T score calculation and to improve work efficiency.