摘要
目的 在社区人群中进行跟骨定量超声法（QUS）骨强度（STI）与双能X线吸收法（DXA）腰椎和髋部骨密度（BMD）测量的临床对比,探讨QUS在骨质疏松筛查和诊断中的临床应用价值.方法 在上海长风社区对6 105例45岁以上常住户籍居民,采用DXA测定腰椎1～4、双侧髋部BMD值,同时采用QUS测定右侧跟骨STI值,分析两者的相关性,以DXA为金标准评价QUS测定STI在骨质疏松筛查和诊断中的灵敏度、特异度和诊断一致率.结果 DXA和QUS诊断的骨量减少、骨质疏松的患病率分别为38.82％、10.29％和64.50％、4.49％.STI与腰椎、左侧和右侧髋部BMD相关系数分别为0.536、0.574和0.570（P值均＜0.001）.与DXA相比,QUS筛查骨量异常（骨量减少和骨质疏松）的灵敏度为86.16％、特异度为47.57％,诊断骨质疏松的灵敏度为23.57％、特异度为97.70％.结论 QUS测定STI与DXA测定BMD有较好的相关性和一致性,QUS筛查骨量异常的高灵敏度和诊断骨质疏松的高特异度使之成为值得在基层医疗机构推广使用的骨质疏松筛查和诊断工具.
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.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2015年第1期27-30,共4页
Chinese Journal of Internal Medicine
基金
上海市公共卫生重点学科建设计划（12GWZX0103）
上海卫生系统重要疾病联合攻关项目（2013ZYJB0802）
上海市普陀区卫生系统自主创新科研资助项目（普科委[2010]33号）
关键词
骨质疏松
定量超声法
双能X线检查
Osteoporosis
Quantitative ultrasound test
Dual energy X-ray absorptiometry
