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[1]馮強(qiáng)強(qiáng),王玲,程曉光,等.成人非創(chuàng)傷性股骨頭壞死骨密度定量分析[J].中醫(yī)正骨,2018,30(10):25-29.
　FENG Qiangqiang,WANG Ling,CHENG Xiaoguang,et al.Quantitative analysis of bone density of adults with non-traumatic femur head necrosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(10):25-29.
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成人非創(chuàng)傷性股骨頭壞死骨密度定量分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年10期
頁碼:
25-29
欄目:
股骨頭壞死
出版日期:
2018-10-20

文章信息/Info

Title:
Quantitative analysis of bone density of adults with non-traumatic femur head necrosis
作者:
馮強(qiáng)強(qiáng); 王玲; 程曉光; 郭曉忠
(北京積水潭醫(yī)院,北京 100035)
Author(s):
FENG Qiangqiang; WANG Ling; CHENG Xiaoguang; GUO Xiaozhong
Beijing Jishuitan Hospital,Beijing 100035,China
關(guān)鍵詞:
股骨頭壞死;  骨密度;  定量CT
Keywords:
femur head necrosis;  bone density;  quantitative computerized tomography
摘要:
目的:探討成人非創(chuàng)傷性股骨頭壞死患者骨密度的特征。方法:收集2015年6月至2017年6月在北京積水潭醫(yī)院行CT檢查診斷為非創(chuàng)傷性股骨頭壞死的患者(壞死組)。共31例48髖,男36髖、女12髖,年齡(47.42±15.29)歲,ARCO分期Ⅱ期21髖、Ⅲ期27髖。均無骨盆或髖關(guān)節(jié)外傷及手術(shù)史,未進(jìn)行過藥物干預(yù)。同時選取2015年6月至2017年6月因單側(cè)髖關(guān)節(jié)骨折在北京積水潭醫(yī)院行髖關(guān)節(jié)CT檢查的患者(非壞死組)。共52例52髖,男38髖、女14髖,年齡(47.42±15.29)歲,對側(cè)股骨均無異常。采用非同步定量CT測定壞死組股骨頭壞死區(qū)、壞死周圍區(qū)域、股骨頸、大轉(zhuǎn)子、轉(zhuǎn)子間的骨密度,測定非壞死組非骨折側(cè)股骨頭中心、股骨頭邊緣、股骨頸、大轉(zhuǎn)子、轉(zhuǎn)子間的骨密度,并對測得的數(shù)據(jù)做統(tǒng)計(jì)分析。結(jié)果:壞死組壞死區(qū)骨密度大于非壞死組股骨頭中心骨密度[(348.44±78.77)mg·cm-3,(284.05±45.88)mg·cm-3,t=4.942,P=0.000]; 壞死組壞死周圍區(qū)域骨密度大于非壞死組股骨頭邊緣骨密度[(218.59±47.82)mg·cm-3,(141.37±31.93)mg·cm-3,t=9.419,P=0.000]; 2組股骨頸、大轉(zhuǎn)子、轉(zhuǎn)子間骨密度比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(98.63±58.43)mg·cm-3,(81.14±63.78)mg·cm-3,t=1.426,P=0.157;(45.38±37.15)mg·cm-3,(52.55±31.23)mg·cm-3,t=-1.048,P=0.297;(48.14±34.07)mg·cm-3,(45.37±42.60)mg·cm-3,t=0.357,P=0.722]。壞死組ARCOⅡ期壞死周圍區(qū)域骨密度大于非壞死組股骨頭邊緣骨密度[(228.97±49.64)mg·cm-3,(141.37±31.93)mg·cm-3,t=7.486,P=0.000]; 壞死組ARCOⅡ期壞死區(qū)、股骨頸、大轉(zhuǎn)子、轉(zhuǎn)子間骨密度與非壞死組比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(307.31±64.15)mg·cm-3,(284.05±45.88)mg·cm-3,t=1.513,P=0.141;(100.71±45.88)mg·cm-3,(81.14±63.78)mg·cm-3,t=1.277,P=0.206;(65.39±26.72)mg·cm-3,(52.55±31.23)mg·cm-3,t=1.653,P=0.103;(59.97±31.76)mg·cm-3,(45.37±42.60)mg·cm-3,t=1.417,P=0.161]。壞死組ARCOⅢ期壞死區(qū)骨密度大于非壞死組股骨頭中心骨密度[(380.42±74.99)mg·cm-3,(284.05±45.88)mg·cm-3,t=6.110,P=0.000]; 壞死組ARCOⅢ期壞死周圍區(qū)域骨密度大于非壞死組股骨頭邊緣骨密度[(210.52±45.64)mg·cm-3,(141.37±31.93)mg·cm-3,t=7.853,P=0.000]; 壞死組ARCOⅢ期大轉(zhuǎn)子骨密度小于非壞死組[(29.81±37.03)mg·cm-3,(52.55±31.23)mg·cm-3,t=-2.879,P=0.005]; 壞死組ARCOⅢ期股骨頸、轉(zhuǎn)子間骨密度與非壞死組比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(97.01±67.43)mg·cm-3,(81.14±63.78)mg·cm-3,t=1.029,P=0.307;(38.94±33.49)mg·cm-3,(45.37±42.60)mg·cm-3,t=-0.682,P=0.497]。ARCOⅡ期壞死區(qū)骨密度小于ARCOⅢ期(t=-3.565,P=0.001),大轉(zhuǎn)子、轉(zhuǎn)子間骨密度均大于ARCOⅢ期(t=3.771,P=0.001; t=2.208,P=0.032); ARCOⅡ期壞死周圍區(qū)域、股骨頸骨密度與ARCOⅢ期比較,差異均無統(tǒng)計(jì)學(xué)意義(t=1.337,P=0.188; t=0.225,P=0.823)。結(jié)論:股骨頭壞死區(qū)和壞死周圍區(qū)域骨密度較正常股骨頭增高。
Abstract:
Objective:To explore the characteristics of bone density of adults with non-traumatic femur head necrosis(FHN).Methods:Thirty-one patients who were diagnosed as non-traumatic FHN(necrotic group)by computerized tomography(CT)examination in Beijing Jishuitan Hospital from June 2015 to June 2017 were collected.The patients(48 hips)consisted of males(36 hips)and females(12 hips),and ranged in age of 47.42+/-15.29 years,and the FHN belonged to ARCO phaseⅡ(21 hips)and ARCO phaseⅢ(27 hips).None of these patients had a history of trauma and surgery of pelvis or hip and received any drug intervention.Meanwhile,fifty-two patients who received hip CT examination for unilateral hip fracture(non-necrotic group)in Beijing Jishuitan Hospital from June 2015 to June 2017 were selected.The patients(52 hips)consisted of males(38 hips)and females(14 hips),and ranged in age of 47.42+/-15.29 years,and no abnormality was found in contralateral femur.The bone density of FHN area,FHN surrounding area,femoral neck,greater trochanter and intertrochanteric area of necrotic group and the bone density of center of femoral head,edge of femoral head,femoral neck,greater trochanter and intertrochanteric area of non-fractured side of non-necrotic group were determined by using non-synchronous quantitative CT,and then the measured data were statistically analyzed.Results:The bone density of FHN area of necrotic group was higher than that of center of femoral head of non-necrotic group(348.44+/-78.77 vs 284.05+/-45.88 mg/cm(-3),t=4.942,P=0.000).The bone density of FHN surrounding area of necrotic group was higher than that of edge of femoral head of non-necrotic group(218.59+/-47.82 vs 141.37+/-31.93 mg/cm(-3),t=9.419,P=0.000).There was no statistical difference in the bone density of femoral neck,greater trochanter and intertrochanteric area between the 2 groups(98.63+/-58.43 vs 81.14+/-63.78 mg/cm(-3),t=1.426,P=0.157; 45.38+/-37.15 vs 52.55+/-31.23 mg/cm(-3),t=-1.048,P=0.297; 48.14+/-34.07 vs 45.37+/-42.60 mg/cm(-3),t=0.357,P=0.722).The bone density of FHN surrounding area(ARCO phaseⅡ)of necrotic group was higher than that of edge of femoral head of non-necrotic group(228.97+/-49.64 vs 141.37+/-31.93 mg/cm(-3),t=7.486,P=0.000).There was no statistical difference in the bone density of FHN(ARCO phaseⅡ)area,femoral neck,greater trochanter and intertrochanteric area between necrotic group and non-necrotic group(307.31+/-64.15 vs 284.05+/-45.88 mg/cm(-3),t=1.513,P=0.141; 100.71+/-45.88 vs 81.14+/-63.78 mg/cm(-3),t=1.277,P=0.206; 65.39+/-26.72 vs 52.55+/-31.23 mg/cm(-3),t=1.653,P=0.103; 59.97+/-31.76 vs 45.37+/-42.60 mg/cm(-3),t=1.417,P=0.161).The bone density of FHN area(ARCO phaseⅢ)of necrotic group was higher than that of center of femoral head of non-necrotic group(380.42+/-74.99 vs 284.05+/-45.88 mg/cm(-3),t=6.110,P=0.000).The bone density of FHN(ARCO phaseⅢ)surrounding area of necrotic group was higher than that of edge of femoral head of non-necrotic group(210.52+/-45.64 vs 141.37+/-31.93 mg/cm(-3),t=7.853,P=0.000).The bone density of greater trochanter was lower in necrotic group(ARCO phaseⅢ)compared to non-necrotic group(29.81+/-37.03 vs 52.55+/-31.23 mg/cm(-3),t=-2.879,P=0.005).There was no statistical difference in the bone density of femoral neck and intertrochanteric area between necrotic group(ARCO phaseⅢ)and non-necrotic group(97.01+/-67.43 vs 81.14+/-63.78 mg/cm(-3),t=1.029,P=0.307; 38.94+/-33.49 vs 45.37+/-42.60 mg/cm(-3),t=-0.682,P=0.497).The bone density of FHN area was lower and the bone densities of greater trochanter and intertrochanteric area were higher in ARCO phaseⅡcompared to ARCO phaseⅢ(t=-3.565,P=0.001; t=3.771,P=0.001; t=2.208,P=0.032).There was no statistical difference in the bone density of FHN surrounding area and femoral neck between ARCO phaseⅡand ARCO phaseⅢ(t=1.337,P=0.188; t=0.225,P=0.823).Conclusion:The bone densities are higher in FHN area and FHN surrounding area compared to normal femoral head.

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通訊作者:郭曉忠 E-mail:[email protected]
更新日期/Last Update: 2019-02-25