中国全科医学2016，Vol.19Issue(14)：1629-1632,4.DOI:10.3969/j.issn.1007-9572.2016.14.005
超声骨密度检查对社区绝经后妇女骨质疏松症筛查效果评价
Evaluation of the Effect of Calcaneus Quantitative Ultrasound Bone Mineral Density Test on the Screening of Osteoporosis in Postmenopausal Women
摘要
Abstract
Objective To observe the effect of calcaneus quantitative ultrasound bone mineral density test(QUS)on the screening of osteoporosis in postmenopausal women. Methods From August 2011 to July 2012,we chose one community health service center from each of four districts in Beijing,namely Beijing Xicheng North District,Xicheng South District, Dongcheng District and Haidian District,by purpose sampling method. The four community health service centers were Yuetan Community Health Service Center of Fuxing Hospital Affiliated to Capital Medical University,Guangnei Community Health Service Center,Tiantan Community Health Service Center and Shuangyushu Community Health Service Center. Volunteers were enrolled from each community health service center as subjects,and 717 postmenopausal women who accorded with inclusion and exclusion criteria were enrolled. According to age,the subjects were divided into three groups:≤59 group(n = 304),60 _69 group(n = 231)and ≥70 group(n = 182). All subjects received bone mineral density test by both DXA and QUS,with the result of DXA as the golden criterion. The bone mineral density of femoral neck bone was measured by DXA,with T value showing the result. The bone mineral density of calcaneus of both feet was measured by QUS,with T value showing the result and the lowest T value was taken as research data. Results DXA bone mineral density test showed that,among 717 postmenopausal women,there were 241(33. 6% )subjects who had normal bone mineral density,341(47. 6% )subjects who had low bone mineral density,and 135(18. 8% )who had osteoporosis. The three groups were significantly different in the bone density tested by DXA(P < 0. 05). With age increasing,the proportion of subjects with low T value( T value≤ _ 2. 5)increased (χ2 trend = 123. 381,P < 0. 001). QUS showed that,among 717 postmenopausal women,there were 53(7. 4% )with T value≥ _ 1. 0,and 152(21. 2% )with _ 1. 5≤T value < _ 1. 0,243(33. 9% )with _ 2. 0≤T value < _ 1. 5,156(21. 8% ) with _ 2. 5 < T value < _ 2. 0,and 113(15. 8% )with T value≤ _ 2. 5. The three groups were significantly different in the bone density of postmenopausal women tested by QUS(P < 0. 05). With age increasing,the proportion of subjects with low T value increased(χ2trend = 47. 643,P < 0. 001). The bone mineral density detected by DXA was positively correlated with that detected by QUS(r = 0. 488,P < 0. 05). The AUC of QUS diagnosing osteoporosis was 0. 793 with 95% CI(0. 752,0. 834). The AUC of the T value of bone mineral density tested by QUS < _ 2. 0 in the diagnosis of osteoporosis was 0. 734 with 95% CI (0. 687,0. 781),and the sensitivity,specificity,total consistent rate,Youden's index and Kappa value of T value = _ 2. 0 in the diagnosis of osteoporosis were 75. 6% ,71. 3% ,72. 1% ,46. 9% and 0. 339 respectively. The AUC of T value < _ 2. 2 in the diagnosis of osteoporosis was 0. 716 with 95% CI(0. 664,0. 768),and the sensitivity,specificity,total consistent rate, Youden's index,and Kappa value of T value = _ 2. 2 in the diagnosis of osteoporosis were 60. 7% ,82. 5% ,78. 4% ,43. 2%and 0. 379. Conclusion QUS can be applied as a screening tool for osteoporosis in postmenopausal women. As a clinical value of diagnosis,T value = _ 2. 0 has good sensitivity and specificity,while the definite diagnosis needs further bone mineral density test by DXA.关键词
骨质疏松,绝经后/超声检查/骨密度/筛查Key words
Osteoporosis,postmenopausal/Ultrasonography/Bone density/Screening分类
医药卫生引用本文复制引用
闫岩,孙艳格,杜雪平,黄凯,于溯..超声骨密度检查对社区绝经后妇女骨质疏松症筛查效果评价[J].中国全科医学,2016,19(14):1629-1632,4.基金项目
北京市西城区2013年优秀人才培养资助项目 （）
