浙江省2769例健康人群跟骨骨密度测量结果及分析

目的为确定我国健康人群超声骨密度的参考值和骨质疏松症的诊断标准提供科学依据。方法采用美国Lunar公司生产的Ach illes Express跟骨超声骨密度测定仪,对2769名健康人(男1262名,女1507名)进行跟骨硬度指数的测定,了解浙江省不同性别健康人的跟骨超声骨密度随年龄、身高、体重等的变化规律及骨质疏松患病率情况,根据不同性别,每5岁为1个年龄组,64岁以上合并为1组,男女各共12组,对相关数据进行统计学分析。结果男女跟骨硬度指数的峰值分别出现在20~24岁和15~19岁,此后随年龄增长均逐渐下降,55岁以后女性硬度指数下降速度比男性快,骨质疏松患病率也高于男性。所用仪器(以日本“年轻成年人”为参照)得出的硬度指数T值与实际T值(以本研究人群“年轻成年人”为参照)差异存在统计学意义(仪器T值,男性不同年龄组χ2检验:χ2=71.049,df=18,P<0.01;女性:χ2=237.828,df=18,P<0.01;实际T值,男性不同年龄组:χ2=69.897,df=18,P<0.01;女性:χ2=239.324,df=18,P<0.01)。结论男女跟骨硬度指数与年龄、身高、体重均有相关性。目前所用进口仪器参照人群的骨密度分布与中国人并不完全相符,诊断中国人的骨质疏松尚需确定适合中国人自己的诊断标准。

Bone density of calcaneus of 2769 healthy persons in Zhejiang province

OBJECTIVE: To provide a scientific basis for the diagnosis and prevention of osteoporosis in Chinese populations. METHODS: The stiffness index (STI) of the calcaneus was measured with the Achilles Express ultrasound apparatus made in USA among 2769 healthy persons, 1262 males and 1507 females, aged 10 to over 60, in Zhejiang province. The relationships between the STI and sex and age were analyzed. RESULTS: The peak STI appeared in the age 20 - 24 among the males, and appeared in the age 15 - 19 among the females. Beyond these age periods the STI decreased along with the age. The STI values of the males aged over 54 were significantly higher than those of the females the same age. The speed of STI decrease of the females aged over 55 was higher than the males of the same age (P < 0.01). The prevalence of osteoporosis was higher in the females than in the males. The STI was negatively correlated with age, and positively correlated with height and body weight in both sexes. The practically measured T values were mostly significantly lower than the instrument' T values (with young adult Japanese as reference population). CONCLUSION: There are significant relationships between STI and age, height, and body weight in both males and females. The distribution of bone mineral density of the reference population for the imported instrument does not completely accord with that of Chinese. It is necessary to establish a standard adaptable to the specific condition of Chinese.