【摘要】 目的 使用双能X线吸收测量仪(dual energy X-ray absorptiometry, DXA)对肩袖撕裂(rotator cuff tear, RCT)患者的患肩肱骨大结节足印区的骨密度(bone mineral density, BMD)进行测量，并研究各术前临床因素对该区BMD的影响。方法 选取2019年5月至2021年12月收治的75例RCT患者，收集年龄、性别、体质量指数(body mass index, BMI)、病程时间、术前DXA检测的腰椎及股骨近端BMD、关节镜术中记录的肩袖撕裂大小及退缩程度(Patte分类)等临床资料。使用特定体位的DXA测量患肩肱骨大结节足印区感兴趣区(region of interest, ROI)的BMD。统计分析各临床资料与肱骨大结节足印区BMD的相互关系，及其对肱骨大结节足印区BMD的影响。结果 RCT患者平均肱骨大结节足印区BMD为(0.596±0.225)g/cm~2。男性肱骨大结节足印区BMD高于女性(t=4.509,P=0.000);不同年龄组及退缩程度组间肱骨大结节足印区BMD差异无统计学意义(P>0.05)。各临床指标中，仅性别、腰椎BMD与肱骨大结节足印区BMD中度相关(r=0.410,P=0.000;r=0.407,P=0.000),股骨近端BMD与肱骨大结节足印区BMD弱相关(r=0.320,P=0.005),余无明显相关(均P>0.05)。逐步线性回归分析显示，仅性别和腰椎BMD对肱骨大结节足印区BMD产生影响(性别的显著性为0.007,腰椎BMD的显著性为0.009)。结论 除了性别及腰椎BMD,其他临床指标无法准确预测肩袖撕裂患者肱骨大结节足印区BMD。本研究采用DXA对肱骨大结节足印区BMD进行直接测量，有一定的临床普及价值。更多还原

【Abstract】 Objective To measure the bone mineral density(BMD) in the footprint of the greater tuberosity of humerus in patients with rotator cuff tear(RCT) by dual energy X-ray absorptiometry(DXA), and to study the influence of various preoperative clinical factors on the BMD in this area. Methods A total of 75 RCT patients were selected from May 2019 to December 2021 to collect clinical characteristics, such as age, gender, body mass index(BMI), duration of disease, BMD of lumbar spine and proximal femur measured by preoperative standard DXA, size and retraction degree of RCT recorded during arthroscopy. The BMD of region of interest(ROI) in the footprint of the greater tuberosity of affected shoulder was measured by DXA in a specific position. The relationship between clinical characteristics and BMD of greater tuberosity of humerus and its impact on BMD were statistically analyzed. Results The mean BMD of greater tuberosity of humerus in RCT patients was(0.596±0.225) g/cm~2. The BMD of greater tuberosity of humerus in men was significantly higher than that in women(t=4.509, P=0.000). There was no significant difference in BMD of greater tuberosity of humerus between different age groups and tendon retraction groups(P>0.05). Among the clinical characteristics, only gender and lumbar BMD were moderately correlated with BMD of greater tuberosity of humerus(r=0.410, P=0.000; r=0.407, P=0.000). Proximal femoral BMD was weakly correlated with BMD of greater tuberosity of humerus(r=0.320, P=0.005). Stepwise linear regression analysis showed that only gender and lumbar BMD had effects on BMD of greater tuberosity of humerus(gender: P=0.007; lumbar BMD: P=0.009). Conclusion In addition to gender and lumbar BMD, other clinical characteristics cannot accurately predict the BMD in the footprint of the greater tuberosity of humerus in RCT patients. The DXA detection method in this study can directly measure the BMD in the footprint of the greater tuberosity of humerus, and it has certain clinical value.更多还原