【摘要】 目的:应用超声骨密度/骨质量测量仪对东莞地区中老年非暴力性骨折患者进行检测,探讨各参数的变化规律及临床意义,并确立骨折的骨密度阈值。方法:①实验对象:选择2003-09/2006-08在东莞石龙人民医院进行超声骨密度测定的非暴力性骨折东莞地区中老年患者107例,男30例,女77例;同期同龄进行超声骨密度测定的无骨折求诊者392例,作为对照组,男83例,女309例。②实验分组:根据年龄分为3个时期:46～60岁为老年前期、61～75岁为老年期、76岁以上为高龄期,以及相应男女组及骨折与非骨折组。③实验方法:采用法国DMS公司UBIS5000型超声骨密度/骨质量测量仪对中老年非暴力性骨折者、无骨折就诊者进行超声骨密度测量。④实验评估:比较两组男女及不同年龄段超声振幅衰减平均值、超声传播速度、骨硬度指数、T值(代表患者测量值如超声振幅衰减平均值和20岁正常人的测量值之间的差异)、Z值(代表患者测量值如超声振幅衰减平均值和同龄正常人的测量值之间的差异)。结果:两组499例患者全部进入结果分析。①总体比较:男、女性骨折组与非骨折组比较,除超声传播速度差别无统计学意义外(P>0.05),其余指标(超声振幅衰减、骨硬度指数、T值、Z值)非骨折组高于骨折组(P<0.01)。②分年龄组比较:老年前期组与总体一致,老年组、高龄组主要指标无统计学意义。应用方差分析对女性骨折组各年龄组之间进行比较,除骨硬度指数外(P<0.05),其余指标差异无显著性;男性骨折组各年龄组之间比较得出与女性一样结果。③男性与女性骨折组比较:除T值男性组高于女性组外(P<0.01),其余指标(超声振幅衰减、超声传播速度、骨硬度指数、Z值)差异均无统计学意义。结论:①中老年人群骨质下降至一定程度(相应测量参数为骨折阈值)时容易发生脆性骨折。②致脆性骨折的骨质量条件与性别、年龄因素无明显相关性。③东莞地区步入老年期后不论男女骨质疏松现象相当普遍,是否会出现骨折关键在于有否外力作用,对其预防性诊断很有价值。更多还原

【Abstract】 AIM: To detect the bone mineral content of patients with non-violent fracture from Dongguan District by ultrasonic determination, and discuss the change rules and clinical significance of every parameter, so as to confirm the bone density threshold value of fracture.METHODS: ①107 middle aged and aged patients including 30 males and 77 females with non-violent fracture who underwent ultrasonic bone densitometry in Shilong People’s Hospital were selected from September 2003 to August 2006. Meanwhile, 392 people including 83 males and 309 females of the same old without fracture were selected as control. ②They were divided into three groups according to their ages: presenium group of 46-60 years, senectitude group of 61-75 years and aged group of 76 years above; additionally, they were divided into male group and female group, fracture group and non-fracture group. ③The subjects were given ultrasonic bone densitometry with UBIS5000 ultrasonic machine (DMS Company, France). ④The mean of broad ultrasound attenuation, transonic velocity, bone stiffness, T value that is the difference in parameter between the patients and 20-year-old normal people, and Z value that is the difference in parameter between the patients and normal people at the same age. RESULTS: All 499 cases were involved in the result analysis. ①Except the velocity (P > 0.05), all parameters such as broad ultrasound attenuation, bone stiffness, T value and Z value in the male and female fracture groups were higher than those of non-fracture group (P < 0.01). ②There was no significant difference in those parameters between the senectitude group and aged group. The variance analysis showed that there was no significant difference in all parameters except stiffness in each age group of female fracture patients (P < 0.05), and so was the male fracture group. ③Except that T value of males was higher than that of females (P < 0.01), no statistical significance was found in broad ultrasound attenuation, transonic velocity, bone stiffness, and Z value.CONCLUSION: ①Fragile fracture is always found in middle aged and aged populations as their bone density has decreased to certain extant; ②fragile fracture is not noticeably correlated with gender, or age; ③osteoporosis is common in male and female old people in Dongguan; external force is an important factor for the fracture, so it is valuable for the preventive diagnosis.更多还原