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目的纵向观察长沙市马王堆乡骨质疏松防治社区女性不同骨骼部位年骨丢失率及其与绝经时间的关系。方法用DXAQDR4500A型扇形束骨密度仪测量220例年龄36~60岁妇女的腰椎,髋部和桡骨远端的骨密度(BMD),3.9~4.1年后复测骨密度,求得年骨丢失速率。结果髋部股骨颈和桡骨远端开始明显骨丢失是在绝经前组;腰椎前后位L1-L4(AP)和髋部大转子在围绝经组已发生明显骨丢失;骨丢失在绝经早期组最快,AP、股骨颈、大转子及桡骨远端年骨丢失率分别为1.70%、2.21%、1.92%和1.56%;骨丢失在绝经晚期趋缓。年龄与绝经后妇女AP、大转子和桡骨远端的年骨丢失率呈正相关(γ=0.223~0.547,P<0.05~0.01)。绝经年限与绝经后妇女AP、大转子的年骨丢失率呈正相关(γ=0.432~0.569,P<0.05~0.01)。体重、体重指数与绝经后妇女AP、股骨颈、大转子的年骨丢失率呈负相关(γ=0.239~0.466,P<0.05~0.01)。结论不同骨骼部位的年骨丢失速率存在差异。年龄、绝经年限与体重影响不同骨骼部位的骨丢失。
Objective To observe longitudinally the rate of annual bone loss in different skeletal areas of osteoporosis prevention and control women in Mawangdui Township of Changsha City and its relationship with menopause time. Methods The bone mineral density (BMD) of lumbar spine, hip and distal radius of 220 women aged 36 to 60 years were measured by DXAQDR4500A fan-shaped bone densitometer. The bone mineral density was measured after 3.9 to 4.1 years and the rate of annual bone loss . Results Significant bone loss began to occur in the femoral neck and the distal radius of the hip in the premenopausal group. Significant bone loss occurred in the peri menopausal group with L1-L4 (AP) anterior and posterior lumbar vertebrae and in the peri-menopausal group. Fast, AP, femoral neck, greater trochanter and distal radius of the distal bone loss rates were 1.70%, 2.21%, 1.92% and 1.56% respectively; bone loss slowed down in the late menopause. There was a positive correlation between age and the annual bone loss rate of AP, the greater trochanter and the distal radius in postmenopausal women (γ = 0.223-0.547, P <0.05-0.01). The age of menopause was positively correlated with the annual bone loss rate of AP and greater trochanter in postmenopausal women (γ = 0.432-0.569, P <0.05-0.01). The body weight and body mass index were negatively correlated with the annual bone loss rate of AP, femoral neck and greater trochanter in postmenopausal women (γ = 0.239-0.466, P <0.05-0.01). Conclusion There are differences in the rate of annual bone loss at different skeletal sites. Age, menopause and weight affect bone loss at different bone sites.