摘要
股骨颈骨密度目前已经成为诊断骨质疏松的金指标。世界卫生组织(WHO)建议骨质疏松的诊断标准为骨密度T值小于-2.5个标准差(SD)。由于这一诊断标准在全世界各地普遍造成误诊与漏诊现象,所以在过去的十几年里,世界各地都在调整自身的当地诊断标准。但这种当地化的标准并没有改善骨质疏松诊断中存在的误诊及漏诊现状。本文分析了个体间骨峰值的差异(54.3％),并讨论了体重与骨峰值的相关性(0.97)。股骨颈骨强度分析的结果是,尽管个体间骨密度峰值差别很大,但股骨颈能支撑体重的倍数(抗骨折能力)却都比较接近(11.9±1.5).因此骨密度或其T值只能说明受试者骨量的多少,不能说明骨质疏松的程度。本文对44例受试者的测试结果、临床症状、及问诊资料进行了综合分析,确诊有7名骨质疏松病人。根据骨密度的T值在44名受试者中共诊断出5名骨质疏松病人,这5名中有3名在上述7名病人之列(确诊),另外2名属于将正常人误诊为骨质疏松(误诊),共漏诊了4名骨质疏松病人(漏诊)。被误诊的受试者体重较轻(小于62千克),而被漏诊的病人体重较重(大于74千克).临床上依据骨密度T值诊断骨质疏松容易将骨骼正常且体重较轻的受试者误诊为骨质疏松病人,而将已经患有骨质疏松且体重较大的病人漏诊。
Femoral neck bone density has become the gold standard for the diagnosis of osteoporosis. The World Health Organization (WHO) suggests that bone density with T-Score less than -2.5 Standard Deviation (SD)be advised as osteoporosis. In the last decade, this diagnosis standard frequently results in incorrect diagnosis; many nations, therefore, have carried out tremendous experiment for achieving their own diagnosis standard. This localized standard, how- ever, has not improved the accuracy for diagnosis. This article analyzes the difference of individual femoral neck peak bone density (54. 3%) and the correlation between body weight and femoral neck peak bone density (up to 0. 97) Although the femoral neck peak bone density differs a lot among individuals, femoral neck strength analysis illustrates that the relative femoral neck strength is extremely close among above individuals (11.9±1.5 times of body weight). The T -score could only represent the bone density or mass, and could not determine the degree of bone loss or osteoporosis. This article analyzes the clinical records of 44 subjects, 7 of whom were diagnosed of osteoporosis with bone density (g/ cm2),femoral neck strength, X-ray, and clinical symptoms. Ali together 5 subjects were diagnosed of osteoporosis with the T -Score of bone density alone; of these 5 subjects, 3 overlap with the 7 osteoporosis patients (True); the other 2 of these 5, who are actually normal, are mistaken as osteoporosis (False alarm); and 4 of the 7 osteoporosis patients are diagnosed to be normal with the T-Score (Missed). The body weight of the 2 subjects in 'False alarm' group are low (<62 kg), and the body weight of the 4 subjects in 'Missed' group are high (>74 kg). The calculation formula of T -Score is liable to represent a lower T-Score for light-weight subjects and a higher T-Score for heavy subjects.
出处
《当代医学》
2000年第9期47-51,共5页
Contemporary Medicine
关键词
体得
骨峰值
骨质疏松
诊断
osteoporosis
bone mineral density
diagnosis standard
