骨质疏松症危险因素及早期筛查诊断进展默沙东.pptVIP

骨松防治 * 跟骨超声的测量方式 Uses and misuses of quantitative ultrasonography in managing osteoporosis,Cleveland clinic journal of medicine, vol.73, 8, Aug.2006, 742-752 不但反映骨密度，而且反映骨的结构特性 QUS 跟骨超声常用参数--声波速率(SOS*) 超声波在致密物质中的传播速度要比在疏松物质中更快，通常在皮质骨的传播速率为3000-3600m/s，而在小梁骨为1650-2300m/s； 健康骨=较快的SOS；骨质疏松症骨=较慢的SOS *SOS: Speed of sound 1.E.Michael Lewiecki, et.al; Uses and misuses of quantitative ultrasonography in managing osteoporosis; Cleveland clinic journal of medicine, vol.73, 8, Aug.2006, 742-752; 2.Steven. Goldstein, et.al; Quantitative ultrasound of the calcaneus: comparison with dual energy X-ray absorptiometry (DXA) of the hip; Presented at the 9th annual meeting of the north American menopause society; Toronto, Sep 16-19, 1998. QUS 超声波在致密物质中频率衰减幅度要比在疏松物质中更大； 健康骨=较高BUA，骨质疏松症骨=较低BUA。 跟骨超声常用参数--宽频超声衰减值(BUA*) *BUA : Broadband ultrasound attenuation, 1.E.Michael Lewiecki, et.al; Uses and misuses of quantitative ultrasonography in managing osteoporosis; Cleveland clinic journal of medicine, vol.73, 8, Aug.2006, 742-752; 2.Steven. Goldstein, et.al; Quantitative ultrasound of the calcaneus: comparison with dual energy X-ray absorptiometry (DXA) of the hip; Presented at the 9th annual meeting of the north American menopause society; Toronto, Sep 16-19, 1998. BUA单位：dB/MHz(分贝/赫兹) QUS 跟骨超声可能应用的应用领域 预测骨折风险 协助诊断骨质疏松症 开始抗骨质疏松症的防治 监测抗骨质疏松治疗疗效 筛查骨质疏松症 QUS ISCD官方2007年对跟骨超声预测骨折风险的评价--基于人种、性别和骨折部位 Marc-Antoine Krieg, et.al; Quantitative ultrasound in the managemnet of osteoporosis: the 2007 ISCD official positions; Journal of Clinical Densitometry: Assessment of Skeletal Health, vol. 11, no. 1, 163e187, 2008 跟骨超声参数指标与骨折风险的相关性 GE-lunar Achilles 参数指标: 足跟硬度指数(heel stiffness index, SI) Hologic Sahara 参数指标: 定量指数(Quantitative index, QUI) SI和QUI为结合BUA和SOS数据结果的复杂指标，单位为m/s。 基于9561例患者的13项研究的综合分析结果显示： 跟骨硬度指数（SI） 1 SD 髋部和脊柱骨折相对风险增加1倍 RR=2.0 所有部位骨折 相对风险增加50% RR=1.5 Hans D,Krieg MA. Quantitative ultrasound for the detection and management of osteoporosis. Salud Publica Mex 2009;51 suppl