【摘要】 目的评价放射吸收法(radiographic absorptiometry,RA)测量指骨骨密度(bone mineral density,BMD)的准确性和对骨质疏松的诊断价值。方法选取志愿者80例(男性30例,女性50例),分别用RA和双能X线骨密度仪(dual energy X-ray absorptiometry,DXA)测量非优势手的2、3、4指中节指骨BMD值和T值(n=80),用DXA测量正位腰椎(n=77)、左侧近段股骨(股骨颈、股骨粗隆及全股骨)(n=78)的BMD值和T值。分别以DXA测量正位腰椎T值、左侧近段股骨T值、RA测量指骨T值进行骨质疏松诊断(T值≥-1.0SD为骨量正常,-2.5SD<T值<-1.0SD为低骨量,T值≤-2.5SD为骨质疏松)。用SPSS11.5软件对RA和DXA测量的指骨BMD值进行相关性分析,对3组骨质疏松诊断结果分别进行一致性分析。结果RA测量与DXA测量指骨BMD值的相关系数=0.864(P<0.01),指骨与腰椎总体诊断符合率为58.4%,指骨与近段股骨总体诊断符合率为56.4%,腰椎与近段股骨总体诊断符合率为68.8%。结论RA测量的指骨BMD值与DXA测量值密切相关,但目前直接使用WHO对DXA测量推荐部位(腰椎、髋部或前臂)BMD制定的诊断标准对RA测量指骨BMD进行骨质疏松的诊断并不合适。更多还原

【Abstract】 Objective To evaluate the accuracy and diagnostic value for osteoporosis of bone mineral density(BMD) of phalanges measured by radiographic absorptiometry(RA).Methods Eighty volunteers were recruited for this study(male=30,female=50),BMD values and T scores of middle phalanges of the index,middle and ring fingers in the non-dominant hand were measured by RA and dual energy X-ray absorptiometry(DXA)(n=80),BMD values and T scores of AP lumbar spine and left proximal femur(femoral neck,trochanter and total femur) were measured by DXA(n=78).The AP lumbar spine measured by DXA,left proximal femur measured by DXA and phalanges measured by RA was individually used to diagnose osteoporosis with the T score(T score≥-1.0SD Normal,-2.5SD<T score<-1.0SD Osteopenia,T score≤-2.5SD Osteoporosis).Data were analyzed with SPSS11.5 software,including the correlation between phalanges BMD values measured by RA and DXA,the diagnosis consistency for osteoporosis between every two methods.Results The correlation coefficient between phalanges BMD values measured by RA and DXA was 0.864(P<0.01),the total diagnostic consistency for osteoporosis between phalanges and AP lumbar spine was 58.4%,phalanges and left proximal femur was 56.4%,AP lumbar spine and left proximal femur was 68.8%.Conclusions BMD value of phalange measured by RA correlated well with that measured by DXA,but it is inappropriate using phalange BMD measured by RA to diagnose osteoporosis directly according to the WHO standard for the recommended sites BMD(lumber spine,hip or forearm) measured by DXA.更多还原