老年人骨折与骨密度及骨代谢生化测定探讨

目的:了解老年人骨折时骨骼的状态。方法:选取60岁以上老年人178例,其中有骨折史者32人,平均年龄69.97±6.25岁,无骨折史者146人,平均年龄 71.33±5.60岁。询问病史及进行骨密度,骨生化代谢指标测定。结果:（1）骨密度下降与骨折发生密切相关,骨折发生的机会依次为骨质疏松组>骨量丢失组>骨量正常组（P<0.05）。（2）骨折部位与此部位骨密度下降有关,腰椎骨密度在腰椎骨折组中降低最多（P<0.01）,而髋部之股骨颈及粗隆间骨密度的下降对髋骨折的发生意义较大（P均<0.01）。（3）骨生化测定仅骨钙素与骨密度呈正相关（P<0.01）。结论:骨质疏松是老年人骨折的重要危险因素,骨密度下降提示骨折可能性增高,要防止老年人骨折必须减少骨量丢失。骨钙素测定可一定程度反映骨密度的量值,对骨质疏松的存在可做一初步的预测。

Fracture of Ederly and Bone Mineral Density(BMD) ,Biochemical Test of Bone Metabolism

: To eveluate the status of fractured bone. Methods: 178 elderly patients (>60years) were investigated by questioniare on fracture history, examed on BMD and biochemical of bone metablism. Results: (1) Decrease of BMD was significantly related to fracture. (2) The sites of fracture were closely related to the local BMD decrease, however, the close relationship was observed between hip fracture and the BMD of femoral neck, interthochanter ( P < 0. 01 ). (3) In biochemical test of bone metablism, only Bone Gla - Protein (BGP) has the positive correlation to BMD (P < 0. 01). Conclusion: Osteoporosis is the important risk factor of fracture of elderly. Decrease of BMD may increase fracture possibility, preventing the decrease of BMD may help decreasing the chance of fracture . BGP may somehow represent BMD, and primarily predict the exist of osteoporosis.