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| 重庆北碚地区中老年人群的定量CT骨密度与脆性骨折评价 |
| Evaluation on the quantitative CT bone mineral density and fragility fracture in the middle-aged and elderly populations in Beibei district, Chongqing |
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| DOI：10.3969/j.issn.1006-7108.2021.06.005 |
| 中文关键词: 定量CT 骨密度 骨质疏松症 脆性骨折 |
| 英文关键词:quantitative CT bone mineral density osteoporosis fragility fracture |
| 基金项目:重庆市北碚区应用开发计划项目（2018-11） |
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| 中文摘要: |
| 目的 探讨重庆北碚地区中老年男性、女性腰椎骨密度（bone mineral density, BMD）的变化规律，以及脊柱脆性骨折的发病特点。方法 本研究选取了两组人群：①常住重庆北碚地区的社区健康人群，年龄40～80岁，共计2 126例；②明确诊断为脊柱脆性骨折的人群，共计137例。两组人群均进行三维定量CT（3D-QCT）BMD测量。将社区健康人群分为中年组（40~59岁）、老年组（60~80岁），比较中老年男性、女性BMD的变化规律；脊柱脆性骨折行CT和（或）MRI检查，至少明确出现一个椎体骨折，MRI明确出现多次骨折，按统计数据绘制ROC曲线，查找脊柱脆性骨折的BMD临界值，分析脊柱脆性骨折的发病特点。结果 社区健康人群组：男性、女性的BMD变化与年龄增长呈负相关（r= -0.747、-0.712，P<0.05）。低骨量高发年龄男女性均在50岁以后，女性50~59 岁(发生率52.5 %)，男性50~69岁(发生率50.2 %)；骨质疏松症（osteoporosis, OP）好发于女性60岁、男性70岁以后。脊柱脆性骨折组：发生于OP人群中女性占83.33 %、男性占67.92 %；发生于低骨量人群中女性占16.7 %、男性占32.1 %。多椎体（多次）脆性骨折发生率为31.39 % (43/137)，其中OP占79.07 %、低骨量占20.9 %；OP+脆性骨折人群中，多椎体（多次）脆性骨折女性占30 %、男性占36.11 %；脆性骨折BMD最佳临界值女性为50.05 mg/cm3、男性71.18 mg/cm3。结论 脆性骨折高发于OP人群、次发生于低骨量人群，OP+脆性骨折患者较低骨量+脆性骨折患者再骨折的风险大。因此，50岁以后应常规检测BMD，关注低骨量，提前干预OP有助于提高脆性骨折的二级预防。 |
| 英文摘要: |
| Objective To investigate the changes in lumbar bone mineral density (BMD) of middle-aged and elderly males and females in Beibei, Chongqing, and the features of spine fragility fracture. Methods There were two groups of people in this study: ① a total of 2 126 healthy residents aged 40-80 years old who live in Beibei, Chongqing; ②a total of 137 cases definitively diagnosed with spine fragility fracture. Three-dimensional quantitative CT (3D-QCT) was performed to measure the BMD in both groups. The healthy group was divided into the middle-aged group (40-59 years old) and the elderly group (60-80 years old) to compare the changes of BMD in middle-aged and elderly males and females. Spine fragility fracture was checked by CT and/or MRI to identify at least one vertebral fracture, and multiple fractures were identified by MRI. ROC curve was drawn in accordance with statistics to find out the optimal critical diagnosis value of BMD in spine fragility fracture, and to analyze the features spine fragility fracture. Results Community healthy group: The changes of BMD on males and females were negatively correlated with age increase (r= -0.747, -0.712，P<0.05). The incidence of low bone mass was relatively high both on males and females after 50 years old (females of 50-59 years old with an incidence of 52.5%, males of 50-69 years old with an incidence of 50.2%); and osteoporosis (OP) tends to occur in females over 60 and males over 70 respectively. Spine fragility fracture group: Among the OP population, females accounted for 83.33%, while males accounted for 67.92%; among people with low bone mass, 16.7% in females and 32.1% in males. The incidence of multi-vertebral (multiple) fragility fracture was 31.39% (43/137), with OP accounted for 79.07% and low bone mass accounted for 20.9%. People with OP and fragility fracture, the figures of multi-vertebral (multiple) fragility fracture were 30% for females and 36.11% for males. The critical value of BMD in fragility fracture was 50.05 mg/cm3 for females and 71.18 mg/cm3 for males. Conclusion The incidence of fragility fracture occurs more frequently in OP populations and secondarily in low bone mass populations. The risk of fracture recurrence in people with OP and fragility fracture is higher than that of who with low bone mass and fragility fracture. Accordingly, it is recommended to check BMD routinely and pay close attention to the low bone mass after 50 years old. Advanced interfere treatment on OP is helpful to improve the secondary prevention of fragility fracture. |
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