[1]刘玉珂,候青青,孔西建,等.骨小梁评分联合腰椎骨密度预测骨质疏松性椎体骨折的价值[J].中医正骨,2025,37(09):26-39.
　LIU Yuke,HOU Qingqing,KONG Xijian,et al.Predictive value of trabecular bone score combined with lumbar bone mineral density for osteoporotic vertebral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(09):26-39.
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骨小梁评分联合腰椎骨密度预测骨质疏松性椎体骨折的价值()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年09期
页码:
26-39
栏目:
基础研究
出版日期:
2025-09-20

文章信息/Info

Title:
Predictive value of trabecular bone score combined with lumbar bone mineral density for osteoporotic vertebral fractures
作者:
刘玉珂; 候青青; 孔西建; 滕军燕; 刘晨晨; 彭媛媛; 杨静; 王娜; 张斌青; 张万义
(河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002)
Author(s):
LIU Yuke; HOU Qingqing; KONG Xijian; TENG Junyan; LIU Chenchen; PENG Yuanyuan; YANG Jing; WANG Na; ZHANG Binqing; ZHANG Wanyi
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
关键词:
骨质疏松性骨折;  脊柱骨折;  骨密度;  骨小梁评分;  风险;  预测;  ROC曲线
Keywords:
osteoporotic fractures;  spinal fractures;  bone density;  trabecular bone score;  risk;  forecasting;  ROC curve
摘要:
目的:探讨骨小梁评分(trabecular bone score,TBS)联合腰椎骨密度对骨质疏松性椎体骨折的预测价值。方法:收集2023年11月至2024年5月采用双能X线吸收法行腰椎骨密度检查的1213例就诊者的病例资料进行分析。根据是否发生骨质疏松性椎体骨折,将受试者分为骨折组和未骨折组。采用受试者操作特征(receiver operating characteristic,ROC)曲线分析TBS和腰椎骨密度预测骨质疏松性椎体骨折的价值。结果:①分组和一般情况组间对比结果。1213例受试者中,761例表现为骨微结构受损或部分受损(TBS<1.310)、347例诊断为骨质疏松症。389例发生骨质疏松性椎体骨折(骨折组),其余824例未发生骨质疏松性椎体骨折(未骨折组)。骨折组的女性比例高于未骨折组(χ2=93.584,P=0.000),年龄大于未骨折组(t=-10.186,P=0.000),体质量指数、TBS、腰椎骨密度均低于未骨折组(t=7.764,P=0.000; t=18.768,P=0.000; t=29.738,P=0.000)。②TBS和腰椎骨密度预测骨质疏松性椎体骨折价值的分析结果。ROC曲线分析结果显示,TBS、腰椎骨密度及二者联合预测骨质疏松性椎体骨折的曲线下面积分别为0.796、0.922、0.923; TBS预测骨质疏松性椎体骨折的曲线下面积小于腰椎骨密度及联合预测(Z=10.266,P=0.000; Z=-10.878,P=0.000),腰椎骨密度与联合预测骨质疏松性椎体骨折的曲线下面积的差异无统计学意义(Z=-0.970,P=0.332)。结论:TBS联合腰椎骨密度对于骨质疏松性椎体骨折具有一定的预测价值,且预测价值高于单纯应用TBS预测,但与单纯应用腰椎骨密度预测相比并无明显增益价值。
Abstract:
Objective:To investigate the predictive value of trabecular bone score(TBS)combined with lumbar bone mineral density(BMD)for osteoporotic vertebral fractures(OVFs).Methods:The medical records of 1213 subjects who underwent examination for lumbar BMD using dual-energy X-ray absorptiometry(DXA)from November 2023 to May 2024 were collected and analyzed.The included subjects were categorized into a fracture group and a non-fracture group based on the presence or absence of OVFs.The predictive value of TBS and lumbar BMD for OVFs was assessed by using the receiver operating characteristic(ROC)curve.Results:①Grouping and inter-group comparison of baseline characteristics.Among the 1213 subjects,761 ones exhibited impaired or partially impaired bone microstructure(TBS<1.310),and 347 ones were diagnosed with osteoporosis; additionally,389 subjects experienced OVFs(fracture group),while 824 ones did not(non-fracture group).Besides,the subjects in the fracture group were older and had a higher proportion of females compared to those in the non-fracture group,and they also demonstrated lower body mass index,TBS,and lumbar BMD(t=-10.186,P=0.000; χ2=93.584,P=0.000; t=7.764,P=0.000; t=18.768,P=0.000; t=29.738,P=0.000).②The predictive value of TBS and lumbar BMD for OVFs.The ROC curve analysis revealed that the areas under the curve(AUC)for TBS,lumbar BMD,and the combination of both in predicting OVFs were 0.796,0.922,and 0.923,respectively.The AUC of TBS in predictive performance was smaller than that of lumbar BMD alone and the combination of both(Z=10.266,P=0.000; Z=-10.878,P=0.000),with no significant difference observed between lumbar BMD alone and the combination of both(Z=-0.970,P=0.332).Conclusion:Combination of TBS with lumbar BMD has certain predictive value for OVFs,and it performs better in predictive performance compared to TBS alone,but it does not exhibit any significant incremental predictive value for OVFs compared to lumbar BMD alone.

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备注/Memo

备注/Memo:
基金项目:河南省科技攻关项目(232102310124)
通讯作者:刘玉珂 E-mail:yukeliu1975@163.com
更新日期/Last Update: 1900-01-01