摘要
目的探究血清降钙素原(procalcitonin,PCT)水平联合定量CT(quantitative computed tomography,QCT)对老年女性疼痛性骨质疏松的诊断价值及与疾病严重程度关系。方法选取2019年1月至2020年4月596例于嘉兴第三医院进行就诊和健康体检的老年女性为研究对象,均行双能量X线、QCT检查、血清PCT检测。分析PCT、QCT对老年女性疼痛性骨质疏松的诊断价值;采用Pearson相关性分析腰椎1、2椎体骨密度、PCT与疼痛性骨质疏松严重程度的相关性。结果596例老年女性中,疼痛性骨质疏松患者占50.84%(303/596),骨量减少者占21.98%(131/596),骨量正常者占27.18%(162/596)。与DAX检查诊断疼痛性骨质疏松结果相比,PCT、QCT、QCT+PCT诊断符合率分别为81.88%(488/596)、93.62%(558/596)、97.31%(580/596)。QCT检查、QCT+PCT诊断符合率高于PCT检测(χ^(2)=43.650、83.187,P<0.001);QCT+PCT诊断符合率高于QCT检查(χ^(2)=9.388,P=0.002)。QCT+PCT检测诊断骨量异常的敏感性、特异性、阳性预测值、阴性预测值均高于PCT检测(P<0.05);QCT+PCT检测诊断骨量异常的特异性、阴性预测值均高于QCT检查(P<0.05)。骨量减少组、疼痛性骨质疏松组人群QCT检测骨密度低于骨量正常组,血清PCT水平高于骨量正常组,差异有统计学意义(P<0.05);疼痛性骨质疏松组人群QCT检测骨密度低于骨量减少组,血清PCT水平高于骨量减少组,差异有统计学意义(P<0.05)。疼痛性骨质疏松严重程度与QCT检测骨密度呈负相关(r=-0.54,P<0.05),与血清PCT呈正相关(r=0.59,P<0.05)。结论QCT椎体骨密度测定联合血清PCT检测诊断疼痛性骨质疏松的准确率、灵敏度、特异性较高,且与疼痛性骨质疏松严重程度密切相关,可用于临床评估疼痛性骨质疏松患者病情。
Objective To explore the diagnostic value of serum procalcitonin(PCT)level combined with Quantitative Computed Tomography(QCT)in elderly women with painful osteoporosis and its correlation with disease severity.Method This study is a prospective study.From Jan.2019 to Apr.2020,596 elderly women who underwent physical examination in our hospital were selected as the research subjects.All of them underwent dual-energy X-ray,PCT examination,and QCT examination serum.The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed;Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1,2 vertebra,PCT and the severity of painful osteoporosis.Result Among 596 elderly women,painful osteoporosis patients accounted for 50.84%(303/596),bone mass reduction accounted for 21.98%(131/596),and normal bone mass accounted for 27.18%(162/596).Compared with the results of the diagnosis of painful osteoporosis by DAX,the diagnostic coincidence rates of PCT,QCT,QCT+PCT were 81.88%(488/596),93.62%(558/596),and 97.31%(580/596).QCT examination,QCT+PCT diagnosis coincidence rate is higher than PCT examination(χ^(2)=43.650,83.187,P<0.05);QCT+PCT diagnosis coincidence rate is higher than QCT examination(χ^(2)=9.388,P=0.002).The sensitivity,specificity,positive predictive value,and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT(P<0.05);the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check(P<0.05).The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group,and the serum PCT level was higher than that in the normal bone mass group,the difference was statistically significant(P<0.05);the painful osteoporosis group was in QCT detection of bone.The density was lower than that of the osteopenia group,and the serum PCT level was higher than that of the osteopenia group,the difference was statistically significant(P<0.05).The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT(r=-0.54,P<0.05),and positively correlated with serum PCT(r=0.59,P<0.05).Conclusion QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy,sensitivity,and specificity in the diagnosis of painful osteoporosis,and is closely related to the severity of painful osteoporosis,and can be used for clinical evaluation of the condition of painful osteoporosis patients.
作者
李建兰
乔宏宇
林涛
Li Jianlan;Qiao Hongyu;Lin Tao(Department of Laboratory,Jiaxing Third Hospital,Jiaxing 314000,China;Department of Radiology,Jiaxing Third Hospital,Zhejiang 314000,China)
出处
《中华内分泌外科杂志》
CAS
2021年第2期189-192,共4页
Chinese Journal of Endocrine Surgery
基金
国家科技支撑计划(2015BAI32H00)
嘉兴市科技计划(2018AD32169)。
关键词
疼痛性骨质疏松
定量CT
降钙素原
骨密度
Painful osteoporosis
Quantitative CT
Procalcitonin
Bone mineral density
