【摘要】 目的探讨绝经后妇女脊椎压缩性骨折与骨密度(BMD)的关系。方法为病例-对照研究,入选250例有脊椎压缩性骨折的绝经后妇女,另有250名无脊椎压缩性骨折的绝经后妇女作为对照组。两组均有胸腰椎正侧位X线摄片,并应用双能X线吸收仪检测腰椎1～4和左股骨近端各部位BMD。结果脊椎压缩性骨折组身高、体重、腰椎2～4和股骨近端各部位BMD值均显著低于对照组(均P＜0．01)。腰椎2～4 BMD是发生脊柱骨折的预报因子(r=-0．416,P＜0．01)。身高和全髋部BMD与骨折次数和骨折椎体数目呈负相关(均P＜0．01)。按股骨颈和全髋部BMD值,骨折组骨质疏松检出率各为50．8%和50．4%；另外剔除在腰椎2～4发生椎体骨折53例,按腰椎2～4 BMD检出骨质疏松占64．5%。同时,腰椎2～4、股骨颈或全髋部BMD值低于-2．5s者发生脊柱压缩性骨折的风险分别是BMD正常者的4．76、2．36和3．52倍。结论腰椎呈低骨量是发生脊椎压缩性骨折的重要危险因素。身高的下降和全髋部低BMD值是骨折发生次数和受累椎体数目的危险因子；对绝经后妇女在重视BMD测量的同时,应重视脊柱X线正侧位检查。更多还原

【Abstract】 Objective To evaluate the association of vertebral compression fractures with bone mineral density（BMD）in postmenopausal women.Methods Two hundred and fifty postmenopausal women with vertebral compression fractures and the other 250 postmenopausal women without vertebral compression fracture as controls were included.All the vertebral fractures were confirmed by posterior-anterior and lateral spine radiographs.The BMD at the lumbar(L_1-4)and proximal femur were measured by dual energy X-ray absorptiometry in both groups. Results Height,body weight and BMD of L2-4 and each site of proximal femur in vertebral fracture group were significantly lower than those in the control group（all P<0.01）.L_2-4BMD was a predictor of vertebral fracture（r =-0.416,P<0.01）.Height and BMD of total hip showed significantly negative correlation with incidences and numbers of vertebral compression fractures（all P<0.05）.As to BMD of femoral neck or total hip in the fracture group,osteoporosis was diagnosed in 50.8% and 50.4% respectively.With the exception of 53 cases suffering from L_2-4vertebral fracture,osteoporosis was diagnosed in 64.5% of the cases based on the BMD of L_2-4. Moreover,subjects with BMD of L_2-4,femoral neck and total hip being<-2.5 s had a 4.76-fold,2.36-fold and 3.52-fold risk of vertebral fracture respectively than the normal BMD subjects.Conclusion Lowered bone mass of the lumbar vertebrae is the major risk factor of vertebral compression fracture.Decreasing of body height and lowered BMD of total hip are the risk factors of incidences and number of vertebral fractures.Attention should be paid to both BMD and spine radiographs in postmenopausal women.更多还原