The Research On Analysis And Evaluation Of The Bone Mass In Postmenopausal Women Based On Bone Mineral Density And Least Significant Change In The Lumbar Spine And Proximal Femurs

Speciality:Orthopedics and Traumatology of TCMAuthor:Wan Chao Supervisor:Professor Zou JiObjective:By detecting small samples of bone mineral density of postmenopausal women in Shiyan city by using dual-energy X-ray absorptiometry, investigated the epidemiology of osteoporosis incidence for those participating in the trial, according to the diagnostic criteria for osteoporosis; By analysising the bone mineral density and the least significant change in the lumbar spine and proximal femurs, provided clinicians important reference for the outcome of the treatment and follow-up diagnosis as judged by patients with osteoporosis; According to differences of the bone mineral density in the lumbar spine and proximal femurs, analyzed the differences which may resulted in the diagnosis of osteoporosis;By analysising the individual factors which can affect the bone mineral density of those parts, found that the incidence factors of osteoporosis which can be regulated, so that we can take appropriate intervention measures to prevent and delay the occurrence of osteoporosis.Methods:Arranged professional operators use dual-energy X-ray absorptiometry to scan twice of lumbar spine and proximal femurs of100postmenopausal women,according to the results of the bone mineral density, analyzed the precision of operator error value, by compliance with the International Society for Clinical Densitometry (ISCD) BMD measurement precision error standard, to ensure the accuracy of measurement of bone mineral density, In order to provide a reliable reference for clinicians to accurately diagnose osteoporosis; Derived from participating in the trial, BMD least significant change in value, can provide important reference for clinicians as judged by patients with osteoporosis outcome of the treatment and follow-up diagnostic;Reference to the osteoporosis diagnostic criteria published by the World Health Organization and the International Society for Clinical Densitometry, made a epidemiological investigation of those people who participated in the trial;Compared the difference results in the diagnosis of osteoporosis caused by different T-score among the lumbar spine and both sides of femoral necks, proximal femurs;Analyzed the relationship between the various parts of the bone mineral density with age, height, weight and BMI index by Pearson correlation analyzed, and then found that protective factors of osteoporosis.Results:Analysised average precision error values of the two operators involved in the research:0.008g/cm2in the lumbar,0.013g/cm2in the left femoral neck0.016g/cm2in the right femoral neck,0.007g/cm2in the left proximal femur and0.007g/cm2in the right proximal femur. All results were in line with the precision errors of the standard recommended by the International Society for Clinical Densitometry (ISCD);Calculated the subjects of the respective detection parts of the least significant change values under the95%confidence interval:0.022g/cm2in the lumbar,0.035g/cm2in the left femoral neck,0.045g/cm2in the right femoral neck,0.020g/cm2in the left proximal femur, and0.019g/cm2in the right proximal femur;Reference to the World Health Organization published diagnostic criteria for osteoporosis, the presence of osteopenia and osteoporosis proportion of the100postmenopausal women who participated in the study:64%in the lumbar,77%in the left femoral neck,62%in the left proximal femur,71%in the right femoral neck,,and63%in the right proximal femur;Analyzed the T-score for100participants, and we found that the average T-score of lumbar spine was higher than both femoral necks and proximal femurs (p<0.05). and the average T-score of right hip was higher than left hip(p<0.05);Pearson correlation analyzed showed that there is a low negative correlation between bone mineral density and age, and a moderate positive correlation between bone mineral density and body weight and BMI index.Conclusions:As dual-energy X-ray absorptiometry has high precision, short scan time, low radiation exposure, and the stable performance of the correction, so it is used as a measurement of gold standard to diagnose osteoporosis and to track the effectiveness of osteoporosis treatment all over the world;The results of the survey showed that the incidence of osteoporosis at a high level in postmenopausal women in shiyan city;By analysising the bone mineral density least significant change in the trail, we can provide clinicians important reference for the outcome of the treatment and follow-up diagnosis as judged by patients with osteoporosis;In view of the test results of bone mineral density have differences among the lumbar spine and both sides of the proximal femurs, We suggest that we should measure not only the lumbar spine but also both proximal femurs in a clinical examination, In order to for clinicians understand the links and differences about BMD among those parts, and fully understand the patient’s bone mass, make a comprehensive diagnosis;We have confirmed the age and bone mineral density in postmenopausal women was positively correlated, and time of menopause was negatively correlated with bone mineral density. As Body weight and BMI index have a moderate positive correlation with bone mineral density, revealed that they are possible protective factors for osteoporosis, so it has a positive effect by maintaining proper weight and BMI values for the prevention and delay the occurrence of osteoporosis.