双能X线骨密度测量和超声骨密度检查在社区绝经后妇女骨质疏松症筛查中应用效果.docVIP

双能X线骨密度测量和超声骨密度检查在社区绝经后妇女骨质疏松症筛查中应用效果 　　[摘要]目的 评价应用双能X线骨密度测量（DXA）和超声骨密度检查（QUS）在社区绝经后妇女骨质疏松症筛查中的效果。方法 选取2016年6～10月我院周围6个社区的186例绝经后女性志愿者，分别应用DXA和QUS检测骨密度，以DXA诊断为金标准，应用线性回归分析年龄与骨质疏松发病率的关系，评价QUS筛查骨质疏松的诊断准确率、敏感度、特异度、阳性预测值、阴性预测值。结果 在纳入研究的186例绝经后女性中，58例（31.19%）骨量正常，74例（39.78%）骨量减少，54例（29.03%）例骨质疏松，且随着年龄段的升高，骨量减少和骨质疏松的发生率明显升高。QUS对骨质疏松的诊断准确率为86.02%，敏感度为74.07%，特异度为90.91%，阳性预测值为76.92%，阴性预测值为89.55%。QUS对骨量减少的诊断准确率为80.65%，敏感度为70.27%，特异度为87.50%，阳性预测值为78.79%，阴性预测值为81.67%。结论 绝经期女性人群中（特别是80岁的老年女性）具有较高的骨量减少和骨质疏松的发生率，超声骨密度检查作为骨质疏松的筛查手段具有较好的特异度，但明确诊断还需进行DXA检查。 　　[关键词]骨质疏松；绝经后妇女；双能X线骨密度测量；超声骨密度检查 　　[中图分类号] R711.5 [文献标识码] A [文章编号] 1674-4721（2017）06（a）-0086-03 　　[Abstract]Objective To investigate the application effect of dual energy X-ray absorptiometry （DXA） and quantitative ultrasound （QUS） bone mineral density test in the screening of postmenopausal osteoporosis in postmenopausal women.Methods From June to October in 2016，186 postmenopausal women volunteers in 6 communities close to our hospital were selected，bone mineral density test was measured by DXA and QUS，respectively.The DXA diagnosis was regarded as the gold standard，the relationship between age and the incidence of osteoporosis was analyzed by by using linear regression analysis，QUS diagnosis of osteoporosis screening accuracy，sensitivity，specificity，positive predictive value and negative predictive value were evaluated.Results Of the 186 postmenopausal women included in the study，58 cases （31.19%） had normal bone mass，74 cases（39.78%） had osteopenia，and 54 cases（29.03%） had osteoporosis，and with the increase of age，osteopenia and osteoporosis incidence rate increased significantly.The accuracy of QUS diagnosis of osteoporosis was 86.02%，sensitivity was 74.07%，specificity was 90.91%，the positive predictive value was 76.92%，the negative predictive value was 89.55%.The accuracy of QUS diagnosis of osteopenia was 80.65%，the sensitivity was 70.27%，the specificity was 87.50%，the positive predictive value was 78.79%，and the ne