【摘要】 目的:分析跟骨定量超声骨质测量中各参数与骨密度及形态计量学指标的相关性。方法:选择2004-01/2005-12广州市第六人民医院和中山大学三院骨科小腿以上截肢患者38例,将其跟骨定量超声测定的超声振幅衰减平均值与健康青年人骨峰值进行比较,>-2.5 SD者为骨量正常组(12例),<-2.5 SD者为骨质疏松组(26例)。分别进行跟骨定量超声、双能X线骨密度测量仪及骨形态计量学测量,应用直线相关分析法分析跟骨定量超声测定中各参数与骨密度及骨组织形态计量学各指标的相关性。结果:38例全部进入结果分析。①骨质疏松组跟骨超声振幅衰减平均值和骨硬度指数值均小于骨量正常组(P<0.01)。②骨量正常组跟骨骨密度值显著高于骨质疏松组[(352±16),(233±14)mg/cm2,P<0.01]。③骨量正常组跟骨平均骨小梁间距或弥散度低于骨质疏松组而松质骨体积高于骨质疏松组(P<0.05)。④超声振幅衰减平均值和骨硬度指数与骨密度呈直线正相关(r=0.814,0.326,P<0.01,0.05)。⑤超声传播速度与骨小梁游离末端、平均骨小梁间距呈直线负相关(r=-0.688,-0.712,P<0.01),与小梁间连点数、松质骨体积呈直线正相关(r=0.672,0.794,P<0.01);骨硬度指数与平均骨小梁间距呈直线负相关(r=-0.358,P<0.05),与松质骨体积呈直线正相关(r=0.513,P<0.01)。结论:跟骨定量超声测量中,超声振幅衰减平均值能较好地反映骨的密度,超声传播速度能较好地反映骨的质量,而骨硬度指数能较综合地反映骨强度的改变。更多还原

【Abstract】 AIM:To investigate the correlation of the parameters in calcaneus quantitative ultrasound measurement with the bone mineral density and bone histomorphometry.METHODS:Thirty-eight patients amputated in lower limb from Department of Orthopedics,Sixth Hospital of Guangzhou and Third Hospital of Sun Yat-sen University were selected between January 2004 and December 2005.Their broadband ultrasound attenuation measured in calcaneus quantitative ultrasound were compared with normal young values:T-score >-2.5 SD as the normal group(n =12),T-score <-2.5 SD as the osteoporosis group(n =26).The two groups were given quantitative ultrasound measurement,dual energy X-ray absorptiometry(DEXA)and Bone Histomorphometry,and the correlation of parameters of calcaneus quantitative ultrasound measurement with bone mineral density and bone histomorphometry was analyzed with linear correlation analysis.RESULTS:All the 38 subjects were involved in the result analysis.①The broadband ultrasound attenuation and bone stiffness of the osteoporosis group were lower than the normal group(P < 0.01).②The calcaneus mineral content of the normal group was significantly higher than the osteoporosis group [(352±16),(233±14)mg/cm2,P < 0.01].③The mean trabecular plate separation or diffusivity of the normal group were lower and trabecular bone volume of the normal group was higher than the osteoporosis group(P < 0.05).④The broadband ultrasound attenuation and bone stiffness were positively related with bone mineral density(r =0.814,0.326,P < 0.01,0.05).⑤The speed of sound was negatively correlated with free end trabecular and mean trabecular plate separation(r =-0.688,-0.712,P < 0.01),and positively correlated with intertrabecular node and trabecular bone volume(r =0.672,0.794,P < 0.01);there was a negative correlation between the stiffness index and mean trabecular plate separation(r =-0.358,P < 0.05),and positive correlation between stiffness index and trabecular bone volume(r =0.513,P < 0.01).CONCLUSION:In the calcaneus quantitative ultrasound measurement,the broadband ultrasound attenuation can better reflect the bone mineral density;the speed of ultrasound can better reflect the bone quality,and the stiffness index can comprehensively reflect the bone strength.更多还原