Lewiecki E M
New Mexico Clinical Research and Osteoporosis Center, Albuquerque, NM 87106, USA.
Minerva Med. 2005 Oct;96(5):317-30.
Bone mineral density (BMD) testing is a clinical tool to diagnose osteoporosis or low bone density, predict fracture risk, and monitor changes in bone density over time. Non-invasive measurement of BMD is done with a variety of technologies for many different skeletal sites. Dual-energy X-ray absorptiometry (DXA) is the gold-standard for diagnosing osteoporosis and monitoring changes in BMD over time. Optimal use of DXA requires staff training and standard operating procedures that include quality controls for instrument maintenance, patient education, indications and contraindications for testing, precision assessment, scan acquisition, analysis, interpretation, and reporting. Other technologies, as well as DXA, are used to estimate the risk of fracture. BMD is commonly expressed as a T-score, the standard deviation variance of the patient's BMD compared to a young-normal reference population. In untreated postmenopausal women, there is a strong correlation between T-score and fracture risk, with fracture risk increasing about two-fold for every standard deviation decrease in bone density. BMD in postmenopausal women is classified as normal, osteopenia, or osteoporosis according to criteria established by the World Health Organization. BMD testing, combined with assessment of clinical risk factors for fracture, allows healthcare providers to identify patients who may benefit from pharmacologic therapy to reduce the risk of future fractures. Clinical applications of BMD testing are presented in this review.
骨密度（BMD）检测是一种临床工具，用于诊断骨质疏松症或低骨密度、预测骨折风险以及监测骨密度随时间的变化。通过多种技术可对许多不同骨骼部位进行无创骨密度测量。双能X线吸收法（DXA）是诊断骨质疏松症和监测骨密度随时间变化的金标准。DXA的最佳使用需要工作人员培训和标准操作程序，包括仪器维护的质量控制、患者教育、检测的适应症和禁忌症、精度评估、扫描采集、分析、解读及报告。除DXA外，其他技术也用于评估骨折风险。骨密度通常用T值表示，即患者骨密度与年轻正常参考人群相比的标准差差异。在未经治疗的绝经后女性中，T值与骨折风险之间存在很强的相关性，骨密度每降低一个标准差，骨折风险增加约两倍。根据世界卫生组织制定的标准，绝经后女性的骨密度分为正常、骨量减少或骨质疏松。骨密度检测与骨折临床风险因素评估相结合，可使医疗服务提供者识别出可能从药物治疗中获益以降低未来骨折风险的患者。本综述介绍了骨密度检测的临床应用。
