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題名 | Measuring Tibial Cortical Bone Status by Ultrasonic Velocity=運用脛骨皮質超音波傳導速度偵測皮質骨質量之應用 |
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作者 | 王素芳; 張政彥; 施純熙; 鄧木火; Wang, Su-fang; Chang, Cheng-yen; Shih, Chunhsi; Teng, Michael Mu-huo; |
期刊 | 中華醫學雜誌 |
出版日期 | 19971000 |
卷期 | 60:4 1997.10[民86.10] |
頁次 | 頁199-204 |
分類號 | 414.93 |
語文 | eng |
關鍵詞 | 皮質; 音波傳導速度; 脛骨; 超音波; Cortex; Speed of sound; Tibia; Ultrasound; |
中文摘要 | 背景:隨著老年人口增加,骨質疏鬆症之防治也日趨重要。骨質疏鬆症引起之骨折會增加社會成本,並降低病患生活品質。因此如何早期診斷骨質疏鬆症以給予適當之預防或治療為一極重要之課題。目前雙能量X光吸收儀為臨床上最常使用之診斷工具,主要測量骨之含量。近年來,以超音波測量骨之質與量為一熱門之題材。本文即運用超音波測量中國婦女脛骨皮質超音波偉導速度,以評估此種檢查是否適用骨質之度量。 方法:205位由臨床轉介之婦女接受超音波對脛骨皮質傳導速度測量。又依是否接受過更年期後黃體激素之預防性治療分為兩類。第一類受檢者為170位未曾接受過更年期後黃體激素預防治療之女性;第二類受檢者含35位曾接受過更年期後黃體激素預防治療之女性。另有3位自願受檢者由兩位技術員各測量三次以計算精確值。本研究將計算出脛骨皮質超音波傳導速度之精確度、平均值,及年齡、更年期、黃體激素使用與否及體型和脛骨皮質超音波傳導速度之相關性。雙能量X光吸收儀測量骨質密度之檢查亦實施於部份第一類受檢者,以比較雙能量X光吸收儀測量骨質密度之檢查和超音波對脛骨皮質傳導速度之相關性。 結果:脛骨之平均皮質超音波傳導速度偵測骨質之精確度小於或等於0.32%,其平均速度為3852±150.3公尺/秒,最快傳導速度發生在31-40歲。每十年傳導速度下降率在31-50歲之間為1.7%,51-70歲之間為4.3%。年齡、更年期及停經後時間、黃體激素使用與否和脛骨皮質超音波傳導速度有很好之相關性。但無數據證實體型和脛骨皮質超音波傳導速度有任何之相關性。雙能量X光吸收儀測量骨質密度之檢查和超音波對脛骨皮質傳導速度有中等程度之相關性。 結論:本文顯示脛骨皮質超音波傳導速度有很好之精確度,並和年齡、更年期、停經後時間及黃體激素使用與否有很好之相關性。但進一步探討皮質超音波傳導速是否對偵測骨疏鬆症引起之骨折有相當之意義仍有其必要性。 |
英文摘要 | Background: Post-menopausal osteoporosis has become a serious public health problem with the increase of the geriatric population. Dual energy x-ray absorptiometry (DEXA) is the most common methoed for diagnosis of osteoporosis by quantitative change of bone, but recently there is increasing interest in measuring both qualitative and quantitative changes of bone by ultrasound. This study measured ultrasound velocity of anterior tibial cortex to evaluate the feasibility of detecting cortical bone status by speed of sound (SOS). Methods: SOS in anterior tibial cortex was measured on 205 females referred from clinicians for routine bone mineral density (BMD) measurement. These females were divided into 2 groups. Group 1 consisted of 170 females aged from 30 to 75 years (mean:55.2±9.3 years), who never received estrogen therapy. Group 2 consisted of 35 females in the post-menopausal status aged ranged from 45 to 69 years (mean:51.5±3.5 years), who had received estrogen gel or oral estrogen tablet (0.625 mg/day) replacement therapy for prevention of postmenopausal osteoporosis for a period of 6 to 68 months (mean:25.3±2.3 months). For precision test, 3 volunteers whose SOS was measured by 2 different operators were also enrolled in our study. BMD by DEXA of L-spine and/or hip was also performed on the same day of SOS examinations. We analyzed the Precision of this new method, calculated mean value of SOS to see if there was any difference with respect to pre- at, and post-menopausal status between estrogen users and nounsers by SOS, and tried to find the relatinship of SOS with body habitus and BMD. Results: Mean value of SOS of group 1 females was 3852±150.3 m/s, with peak value in the fourth decade. There were inverse correlation of SOS with age (r= -0.36, p<0.0005) and the period after menopause (r= -0.32, p<0.0005). The decreasing rate of SOS per decade from 31 to 50 years of age was 1.7%, while that of 51 to 70 years was 4.3% in group1 females. With regard to menopausal status. there was significant difference of SOS between pre- and post-menopausal females (p=0.01, ANOVA test), between at and post-menopausal females (p=0.02). Significant difference (p<0.05, ANOVA test) between group 2 estrogen users and group 1 postmenopausal nousers was also noted. There was no evidence of correlation of body weight or height with SOS. Both inter-and intra-operator precision of SOS was under or equal to 0.32%. Moderately correlation between SOS and BMD was noted. Conclusions: Our study demonstrated good precision in SOS measurement of tibial cortical status. It was inversely correlated with age and post-menopausal period; it also significantly discriminated estrogen users from nonusers, and pre-, at from post-menopausal subgroups. However, for further evaluation of the relationship between SOS and the most severe complication of osteoporosis, i.e. osteoporotic fracture, population-based long-term followup is still required. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。