摘要
【目的】
在建立了双能X线吸收法(Dual energy X-ray absorptiometry，DXA)测量质量控制(Quality control，QC)的基础上，观察广州地区人群左、右侧股骨近端相应感兴趣区的骨矿密度(Bone mineral density，BMD)差异性，重点评价DXA测量绝经妇女双侧股骨近端BMD对单侧诊断结果的影响。以探讨测量双侧股骨近端是否能比单侧提供更多的临床价值，为骨质疏松症(Osteoporosis，OP)诊断测量提供依据。
【方法】
使用GE Lunar Prodigy骨密度仪对腰椎体模进行测量，与真实值比较计算测量的准确度。对30名受试者同时进行了两次骨密度测量，计算各测量部位的精密度和最小显著变化值。对1101例广州地区受试者(女性组817例、男性组284例)进行了双侧股骨近端(股骨颈、股骨转子区、股骨颈上部和整体髋关节)DXA骨密度测量。按照世界卫生组织1994年制定的方案，对于绝经后妇女组(504例)依据双侧股骨近端各测量部位的最低T值进行诊断，比较双侧股骨近端骨密度测量结果在诊断水平上可造成的差异。
【结果】
GE Lunar Prodigy骨密度测量仪的准确度为-0.81％，股骨近端不同部位的单侧测量精密度(RMS—CV％)在0.7-2.2％，而相应部位的双侧测量精密度(RMS—CV％)在0.6-1.2％。双侧测量精密度比单侧测量提高20-45％。总体、男性组、女性组和绝经女性组双侧股骨近端各测量部位BMD值呈高度正相关(r=0.88-0.96，P＜0.01)。仅发现女性组整体髋关节的BMD值双侧存在较小的(0.030g／cm~2)但有统计学意义的差异(P＜0.05)，右侧均高于左侧，其余各组人群各个感兴趣区骨密度双侧无统计学差异。在504
[Objective]
Based on the process of dual-energy X-ray absorptiometry (DXA) densitometry measurement quality control, to investigate the differences of the bone mineral density (BMD) at the bilateral proximal femur and determine the diagnostic value of bilateral femoral BMD measurements in postmenopausal females. [Methods]
Measured the lumbar vertebra phantom supplied by factory daily, and compared the results with real value, then calculated the accuracy. 30 subjects were chosen, each subject was scanned twice, the precision and the least significant change (LSC) of each examinated regions were calculated. Dual femur (femoral neck, upper neck, trochanter and total hip) measurements using GE Lunar Prodigy were performed in 817 women and 284 men in Guangzhou district. 504 postmenopausal women were diagnosed based on the lowest T-score of bilateral measurement sites, using the diagnostic classification established by the World Health Organization. [Results]
The accuracy of DXA densitometer was -0.81%, Measurement precision (RMS-CV%) with single femur was 0.7-2.2%; dual femur precision was 0.6-1.2%, depending on the site. The dual femur mean BMD (average of L/R) provides an additional 20-45% improvement in precision compared to a single femur measurement. Strong correlations (r = 0.86-0.97, P<0.01) were found between left and right femur BMD values in each group. No significant differences between bilateral femoral BMD were observed in total, male and postmenopausal women groups (P>0.05). There was significant but small
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