股骨近端骨密度结合其几何参数在老年人骨质疏松性髋部骨折诊治中的临床意义

目的探讨股骨近端骨密度与几何结构参数在老年人骨质疏松性髋部骨折诊治中的临床意义。方法将65例髋部骨折患者作为实验组。同期健康体检的60例老年志愿者为对照组。在骨盆片上测量股骨近端几何参数，在股骨颈、Ward’S三角和转子处测量BMD值（髋部骨折组对其健侧进行检测），对结果进行比较分析。结果实验组的BMD值低于对照组（P〈0．05）；股骨颈骨皮质厚度与股骨颈BMD值有相关性（r=0．54，P〈0．05）；股骨距内侧皮质厚度、转子处BMD值、颈干角和Ward’s三角BMD值相结合在预测髋部骨折中价值较大（r=0．78，r2=0．57，P〈0．05）。结论股骨近端骨密度结合其几何结构参数在骨质疏松性髋部骨折的诊治中具有较大的临床意义。

Value of bone mineral density combined with proximal femur geometrical parameters in the diagnosis and treatment of hip osteoporotic fracture in elder

Objective To explore the value of bone mineral density （BMD） combined with proximal femur ge ometrical parameters in the diagnosis and treatment of hip osteoporotic fracture in elder. Methods There were 65 patients with hip osteoporotie fractures as experiment group in whom measurements were taken in the eontra lat eral hip. There were 60 age matched health examine volunteers as control group at the same term. The geometri cal parameters were defined from anterioposterior pelvic roentgenograins. BMD was measured at the femoral neck, Ward＇s triangle, and the trochanter area. All the data were analyzed. Results BMD was significantly lower in the experiment group than that in the control group （ P 〈 0.05 ）. It had significant correlation between the femoral neck cortex width and the femoral neck BMD （ r = 0.54, P 〈 0.05 ）. It had important value significance the combination of medical calcar femoral cortex width, the trochanter BMD, neck/shaft angle, and Ward＇s triangle BMD（ r = 0.74, r2 = 0.53, P 〈 0.01 ）in the predictor of hip osteoporotic fracture basing on the step wise lin ear regression analysis. Conclusion It has relative obvious value of bone mineral density（BMD） combined with proximal femur geometrical parameters in the diagnosis and treatment of hip osteolaorotic fracture in elder.