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目的探讨老年髋部骨折术后无应用抗骨质疏松药物治疗患者的骨质变化。方法入选本研究的患者共12例,平均年龄77.6岁,髋部骨折术后平均8.6年。全部患者接受对骨质疏松症认知水平询问;双能X线吸收骨密度仪(DXA)测定5例股骨近端和7例腰椎骨密度,并与在门诊经规范骨质疏松治疗1年以上随机选取的骨质疏松症患者(男3例,女9例,平均年龄74岁)骨密度比较,两组相应部位数值进行t检验;影像学检查包括拍摄骨盆正位片和腰椎X线片,部分患者作腕部X线片或腰椎MR I检查。结果患者对骨质疏松症认知水平低(16%)。腰2、3椎体和股骨近端骨密度均降低,以股骨近端更为明显(P<0.05)。6例人工髋关节假体柄松动,3例髋臼磨损,2例动力髋钢板螺钉和1例股骨近端髓内钉松动伴移位,所有患者腰椎椎体骨小梁稀疏,共有9例椎体呈压缩性骨折,16例椎体呈明显“双凹”征,3例桡骨远端骨小梁稀疏。结论老年髋部骨折术后如无进行抗骨质疏松药物治疗,骨质可能会变得更加脆弱。
Objective To investigate the changes of bone mass in elderly patients with hip fracture without anti-osteoporosis treatment. Methods A total of 12 patients were enrolled in this study, with an average age of 77.6 years and an average of 8.6 years after hip fracture. All patients were asked about the cognitive level of osteoporosis; DXA measured 5 cases of proximal femur and 7 cases of lumbar vertebral bone mineral density, and with the standard osteoporosis in the clinic more than 1 year The bone mineral density of randomly selected patients with osteoporosis (3 males and 9 females with an average age of 74 years) was compared by t-test. The imaging examination included pelvis and lumbar radiographs, Some patients for wrist X-ray or lumbar MRI examination. Results Patients had a low cognitive level of osteoporosis (16%). The lumbar 2, 3 vertebral body and the proximal femur BMD were reduced to the proximal femur (P <0.05). 6 cases of artificial hip prosthesis handle loose, 3 cases of acetabular wear, 2 cases of dynamic hip screw and 1 case of proximal femoral nail with loose displacement, all patients with spondylolisthesis trabecular sparse, a total of 9 cases of vertebral Body compression fractures, 16 cases of vertebral apparent “double concave ” sign, 3 cases of distal radial trabecular bone sparse. Conclusions Elderly patients with hip fracture without anti-osteoporosis medication may become more vulnerable to bone formation.