胫骨超声速率对绝经后椎体骨折危险性的评价

目的观察胫骨超声速率（ＳＯＳ）对绝经后椎体骨折危险性的预测价值。方法选择１９３名绝经后妇女,年龄（５４．４±７．３）岁,绝经年限（１６．０±７．８）ａ,所有受试者均进行ＳＯＳ,腰椎Ｌ２～４,股骨颈（Ｎｅｃｋ）,Ｗａｒｄｓ三角和大转子（Ｔｒｏｃｈ）部位的双能ｘ线吸收法（ＤＥＸＡ）和前臂远端１／３和１／１０的ＳＰＡ骨密度（ＢＭＤ）检查,同时均进行胸腰椎侧位Ｘ线相检查。结果受试者中有５４例至少１个椎体骨折,其余１３９例未发现椎体骨折。ＳＯＳ分别为（３６５１．９±１８８．３）和（３７３１．３±１４０．８）ｍ／ｓ（Ｐ＜０．０１）。骨折组的ＢＭＤ也均低于非骨折组。经Ｌｏｇｉｓｔｉｃ回归分析表明：对椎体骨折危险性的ｏｄｄｓ值ＳＯＳ为１．８６（Ｐ＜０．０１）,低于ＤＥＸＡ的ＢＭＤ（２．２５～３．２８,Ｐ＜０．００１）,而与经ＳＰＡ的ＢＭＤ（１．５０～１．９６）相似。结论绝经后妇女中椎体骨折者的ＳＯＳ较非骨折者有显著降低,胫骨ＳＯＳ对绝经后妇女椎体骨折具有预测作用,ＳＯＳ每降低一个标准差,椎体骨折的危险性增加８６％。

Evaluation of the risk of vertebral fracture predictable with quantitative tibial ultrasound velocity test in postmenopausal women

OBJECTIVE: To investigate predicting value of increased risk of vertebral fracture associated with reduction of tibial ultrasound velocity (SOS) test in postmenopausal women. METHODS: 193 menopausal women aged(54.4 +/- 7.3) years were included in our study. Post menopausal period of these subjects were (16.0 +/- 7.8) years. These participants received tibial ultrasound speed (SOS) test, DEXA for lumbar 2-4, femoral neck wards triangle and trochant, as well as SPA for 1/3 and 1/10 of distal forearm. Vertebral fracture was determined by radiograph of lateral lumbar and thoracic spine. RESULTS: 54 subjects were found at least one vertebral deformation, and no vertebral deformation was found in other 139 subjects. Tibial SOS was significantly lower in subjects with than without vertebral fracture (3,651.9 +/- 188.3) vs (3,731.3 +/- 140.8), P < 0.01], The similar results were also found in BMD. The analysis of logistic regression showed: odds ratio (OR) of SOS to vertebral fracture was 1.86(P < 0.01) when 1 standard deviation of SOS changed. It was lower than OR of BMD by DEXA(2.25-3.28, all P < 0.001), and similar with OR of BMD by SPA (1.50-1.96). CONCLUSIONS: Low SOS was associated with presence of vertebral fracture in postmenopausal women. SOS could predict the risk of vertebral fracture, 86% of the risk of vertebral fracture increased when 1 standard deviation of SOS reduced.