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定量超声检测计算跟骨硬度指数在骨质疏松症筛查与诊断中的临床价值

[The clinical value of calcaneus stiffness index calculated by quantitative ultrasound test in screening and diagnosis of osteoporosis].

作者信息

Hu Yishun, Li Qian, Lin Huandong, Shi Ling, Ma Hui, Chen Yuhua, Gao Xin

机构信息

Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Email:

出版信息

Zhonghua Nei Ke Za Zhi. 2015 Jan;54(1):27-30.

Abstract

OBJECTIVE

To evaluate the diagnostic value of quantitative ultrasound test (QUS) in osteoporosis screening by comparing stiffness index (STI) calculated by QUS and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in Chinese community population.

METHODS

A total of 6 105 residents aged 45 years and over from Shanghai Changfeng community were recruited. BMD of lumbar spine (L1-L4) and both femur measured by DXA and calcaneus STI calculated by QUS were observed simultaneously in the same day. The sensitivity, specificity and accuracy of QUS and DXA (gold standard) on the diagnosis of osteoporosis were compared.

RESULTS

The prevalence of osteopenia or osteoporosis diagnosed by DXA and QUS was 38.82%, 10.29% and 64.50%, 4.49% respectively. STI was correlated with BMD of spine, left and right femur, respectively with the correlation coefficients of 0.536, 0.574 and 0.570 (all P < 0.001). The sensitivity and specificity of QUS for osteopenia was 86.16% and 47.57% and for osteoporosis was 23.57% and 97.70%.

CONCLUSION

STI calculated by QUS had a good correlation with BMD measured by DXA. The high sensitivity and specificity of QUS made it as a diagnostic tool for osteopenia and osteoporosis screening in community health care center.

摘要

目的

通过比较定量超声检测(QUS)计算的硬度指数(STI)与双能X线吸收法(DXA)测量的骨密度(BMD),评估QUS在中国社区人群骨质疏松筛查中的诊断价值。

方法

招募了来自上海长风社区的6105名45岁及以上居民。同一天同时观察DXA测量的腰椎(L1-L4)和双侧股骨的骨密度以及QUS计算的跟骨STI。比较QUS和DXA(金标准)对骨质疏松诊断的敏感性、特异性和准确性。

结果

DXA和QUS诊断的骨量减少或骨质疏松患病率分别为38.82%、10.29%和64.50%、4.49%。STI分别与脊柱、左、右股骨的骨密度相关,相关系数分别为0.536、0.574和0.570(均P<0.001)。QUS对骨量减少的敏感性和特异性分别为86.16%和47.57%,对骨质疏松的敏感性和特异性分别为23.57%和97.70%。

结论

QUS计算的STI与DXA测量的骨密度具有良好的相关性。QUS的高敏感性和特异性使其成为社区卫生保健中心骨量减少和骨质疏松筛查的诊断工具。

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