目的 提高对骨质疏松症(OP)早期诊断的认识.方法 回顾性研究279例确诊脆性骨折患者,经双能X线骨密度仪(DXA)测定骨密度(BMD),探讨不同诊断标准(T值≤-2.5SD和T值≤-2.0SD)对OP的诊断检出率,并对相应的临床特征和危险因素进行比较分析.结果 279例脆性骨折患者以T值≤-2.5SD和T值≤-2.0SD为标准OP诊断检出率分别为51.6%和75.6%,两者比较差异有统计学意义(P＜0.05);其中以T值≤-2.5SD为标准,OP检出组的年龄、有症状者的比例高于非检出组(67.5±12.3 vs 65.3±11.6;27.6% vs 14.7%,P＜0.05),但危险因素总数低于非检出组(36.2% vs 63.8%,P＜0.05);股骨颈BMD随年龄的增长而下降(F=4.3,P＜0.05).结论 以骨密度T值≤-2.0SD作为国人OP诊断标准可能比T值≤-2.5SD的标准更为合适;OP早期诊断需结合临床特征及高危因素,并选择合理BMD测量部位.%Objective To improve the early diagnosis of osteoporosis. Methods Data of 279 patients with fragility fractures, whose bone mineral density ( BMD ) were measured by dual - energy X - ray absrptiometry ( DEXA ),were retrospectively studied. The osteoporosis diagnosis rates according to different criteria ( T≤-2. 5 SD and T≤-2. 0 SD ), general condition, and risk factors of osteoporosis were analyzed. Results Osteoporosis was diagnosed according to criteria of T ≤ -2. 5 SD and T≤-2. 0 SD in 51.6 and 75.6％ , respectively, in 279 patients with ?? fragility fracture.Significant difference was revealed in diagnostic rates according to the two criteria ( P < 0. 05 ). According to T≤-2.0SD, patients diagnosed with osteoporosis presented significantly elder age and more symptomatic the others ( 67. 5 ±12. 3 vs 65.3 ± 11.6, P < 0. 01; 27.6％ vs 14. 7％ , P < 0. 05 ), but with significantly less risk factors for osteoporosis ( 36.2％ vs 63.8％, P <0. 05 ). Moreover, BMD of femoral neck declined with age ( F =4.3, P <0. 05 ). Conclusion The criteria of T≤- 2. 0SD for the diagnosis of osteoporosis may be more appropriate for Chinese population than that of T≤-2. 5SD. Age, typical symptoms, and risk factors, combining with BMD of specific location, should be considered in early diagnosis of osteoporosis.
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