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目的探讨绝经后妇女脆性骨折部位与骨密度(BMD)的关系。方法回顾性研究740例有脆性骨折的绝经后妇女,分析骨折部位和次数与BMD关系,应用双能X线吸收仪检测腰椎1～4和股骨近端BMD值。结果740例患者中,共发生838次骨折,椎体骨折、髋部骨折、桡骨远端骨折和外周骨折分别为192次(22.9%)、53次(6.3%)、159次(19.0%)和434次(51.8%),骨质疏松检出率分别为75.0%、81.1%、57.9%和49.1%,不同部位骨折处骨质疏松检出率间差异有统计学意义(P<0.01)。同时,多次骨折组的年龄显著高于一次骨折组(P<0.05),而其腰椎1～4、大转子(Troch)部位的BMD则显著低于一次骨折组(P<0.05)。结论绝经后妇女脆性骨折以椎体、桡骨远端为常见,髋部骨折较少见;发生髋部骨折者常具有低BMD;多次骨折患者年龄为危险因子。
Objective To investigate the relationship between the location of the fragile fracture and the bone mineral density (BMD) in postmenopausal women. Methods 740 postmenopausal women with brittle fracture were retrospectively studied. The relationship between the number of fractures and BMD was analyzed. BMD of lumbar vertebra 1-4 and proximal femur was detected by dual-energy X-ray absorptiometry. Results A total of 838 fractures were performed in 740 patients. Vertebral fractures, hip fractures, distal radius fractures and peripheral fractures were 192 (22.9%), 53 (6.3%), 159 (19.0%) and 434 times (51.8%). The detection rate of osteoporosis was 75.0%, 81.1%, 57.9% and 49.1% respectively. There was a significant difference in the detection rate of osteoporosis among the fractures at different sites (P <0.01). At the same time, the number of fracture group was significantly higher than that of the primary fracture group (P <0.05). The BMD of the lumbar spine 1-4 and Troch group was significantly lower than that of the primary fracture group (P <0.05). Conclusions Fragile fractures in postmenopausal women are common in vertebral body and distal radius, and hip fractures are rare. Patients with hip fractures often have low BMD and multiple fracture patients are risk factors.