双能X线骨密度仪评估绝经后妇女椎体脆性骨折及相关危险因素的分析

Assessment of vertebral fracture and its related risk factors by dual-energy X-ray absorptiometry in postmenopausal women

摘要:

目的：通过双能X线骨密度仪对绝经后女性椎体脆性骨折的评估，探讨其发生的危险因素。方法：对来院体检的203例50岁以上绝经妇女用双能X骨密度测量仪（dual-energy x-ray absorptiometry，DXA）进行椎体骨折评估（verterbral fracture as－sessment，VFA），并检测不同部位骨密度及相应T值，收集所有受检者一般资料。根据有无椎体骨折及椎体骨折部位分组。结果：胸椎及胸腰椎骨折组骨密度及T值均低于无椎体骨折组；骨质疏松时与无椎体骨折组比较差别有统计学意义（P<0.05）。腰椎骨折组骨密度、T值及骨量变化则均与无椎体骨折组差别无统计学意义。增龄、全髋骨密度及T值降低是椎体骨折的危险因素。结论：骨密度（bone mineral density，BMD）及T值的降低对绝经后妇女胸椎及胸腰椎骨折椎体脆性骨折有重要的预测价值，对腰椎骨折则有局限性。增龄、全髋骨密度及T值降低是椎体脆性骨折的危险因子。对绝经后妇女椎体脆性骨折的防治在重视骨密度的同时要联合进行椎体骨折评估。

Abstract:

Objective：To assess the vertebral fracture by dual-energy X-ray absorptiometry（DXA） and to analyze the risk factors of fragility fracture in postmenopausal women. Methods：Totally 203 postmenopausal women underwent vertebral fracture assessment （VFA） by DXA. Bone mineral density（BMD）（g/m2） at different positions was detected and the corresponding T-score（SD） was attained. All patients were grouped based on whether having vertebral fracture and the different parts of fracture. Results：Low BMD（g/m2） and T-score（SD） in patients with both thoracic fracture and thoracic and lumbar fracture were significantly lower than those without vertebral fracture（P<0.05）. The occurrence of vertebral fracture was affected by age（yr）. Conclusion：Lower BMD（g/m2） and T-score（SD） may be important predictors for thoracic fracture and thoracic and lumbar fracture，while exerts little effect on fracture of lum－bar vertebra. Age（yr），BMD（g/m２） of total hip and T-score（SD） are risk factors for vertebral fracture. BMD（g/m2） com－bined with VFA is recommended in the assessment of vertebral fracture.