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[门诊X线双能骨密度测定在诊断早期骨矿物质密度紊乱及监测绝经后骨质疏松症治疗中的应用]

[Outpatient x-ray dual-energy osteodensitometry in diagnosis of early disorders of mineral bone density and monitoring of postmenopausal osteoporosis treatment].

作者信息

Rubin M P

出版信息

Ter Arkh. 2009;81(1):29-36.

Abstract

AIM

To improve quality of densitometric diagnosis of abnormal bone tissue mineral density (BTMD) in postmenopausal women using the results of densitometry of two adjacent lumbar vertebra and proximal regions of both femoral bones.

MATERIAL AND METHODS

Densitometry (dual-energy x-ray absorptiometry) was made on densitometer Lunar Prodigy in 7731 women: 969 under 50 years of age, 3081--aged 50-65 years (early postmenopause) and 3681--aged 65 years and older. BTMD data were analysed with the system MEDIA-LOG.

RESULTS

In postmenopause metabolic disorders of bone tissue are detectable with a standard analysis of the results of dual x-ray osteodensitometry in about 2/3 (72.14%) patients (at the stage of osteopeny in 33.13% and osteoporosis--in 39.01%). Diagnostic efficiency in consideration of the T-criterion in the adjacent lumbar vertebra in comparison to the integral value L(I)-L(IV) rises in 50-65 year old women in osteoporosis by 7.27% and in osteopeny--by 8.31%; in women over 65 years of age by 10.11 and 3.62%, respectively. Diagnostic value rises in comparison of the results of bilateral examination of the femoral bones with the results of unilateral (left-sided) investigation in women over 50-65 years in osteoporosis by 1.46%, osteopenia--by 1.10%, in women over 65 years--by 3.51 and 226%, respectively. Densitometric picture is not permanent, osteoporosis runs in 2 stages.

CONCLUSION

For early diagnosis of postmenopausal osteoporosis most informative is the analysis of BTMD by three areas: lumbar spine L(I)-L(IV), adjacent vertebra L(I)-L(II), L(II)-L(III), L(III)-L(V) and necks of both femoral bones.

摘要

目的

利用相邻两个腰椎椎体及双侧股骨近端区域的骨密度测量结果,提高绝经后女性异常骨组织矿物质密度(BTMD)的密度测量诊断质量。

材料与方法

使用Lunar Prodigy骨密度仪对7731名女性进行骨密度测量(双能X线吸收法):969名年龄在50岁以下,3081名年龄在50 - 65岁(绝经早期),3681名年龄在65岁及以上。BTMD数据采用MEDIA - LOG系统进行分析。

结果

在绝经后,通过双能X线骨密度测量结果的标准分析,约2/3(72.14%)的患者可检测到骨组织代谢紊乱(骨质减少阶段占33.13%,骨质疏松阶段占39.01%)。与整体值L(I) - L(IV)相比,考虑相邻腰椎椎体的T值标准时,50 - 65岁女性骨质疏松的诊断效率提高7.27%,骨质减少提高8.31%;65岁以上女性分别提高10.11%和3.62%。与单侧(左侧)检查结果相比,双侧股骨检查结果的诊断价值在50 - 65岁女性骨质疏松中提高1.46%,骨质减少中提高1.10%;在65岁以上女性中分别提高3.51%和2.26%。骨密度情况并非一成不变,骨质疏松分为两个阶段。

结论

对于绝经后骨质疏松的早期诊断,最具信息量的是对三个区域的BTMD进行分析:腰椎L(I) - L(IV)、相邻椎体L(I) - L(II)、L(II) - L(III)、L(III) - L(V)以及双侧股骨颈。

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