[1]张翠猛 王玉 王小影 李大全 郭敬然.双能X线骨密度测定法与腰椎CT诊断在骨质疏松患者功能锻炼指导中的应用研究[J].中华老年骨科与康复电子杂志,2026,(02):72-78.[doi:10.3877/cma.j.issn.2096-0263.2026.02.002]
　Zhang Cuimeng,Wang Yu,Wang Xiaoying,et al.Application of Dual-energy X-ray Absorptiometry and Lumbar CT Diagnosis in Functional Exercise Guidance for Osteoporosis Patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2026,(02):72-78.[doi:10.3877/cma.j.issn.2096-0263.2026.02.002]
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双能X线骨密度测定法与腰椎CT诊断在骨质疏松患者功能锻炼指导中的应用研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2026年02期
页码:
72-78
栏目:
骨质疏松
出版日期:
2026-04-05

文章信息/Info

Title:
Application of Dual-energy X-ray Absorptiometry and Lumbar CT Diagnosis in Functional Exercise Guidance for Osteoporosis Patients
作者:
张翠猛 王玉 王小影 李大全 郭敬然
063000 唐山市第二医院脊柱一科
Author(s):
Zhang Cuimeng;  Wang Yu;  Wang Xiaoying;  Yang Haohui;  Guo Jingran.
Department of Spine I, Tangshan Second Hospital, Tangshan 063000, China
关键词:
双能X线骨密度测定法;  腰椎CT;  骨质疏松;  康复锻炼
Keywords:
Double-energy X-ray bone mineral densitometry;  Lumbar CT;  Osteoporosis;  Rehabilitation exercise
DOI:
10.3877/cma.j.issn.2096-0263.2026.02.002
文献标志码:
A
摘要:
目的 探讨双能X线骨密度测定法（DXA）与腰椎CT对骨质疏松症（OP）及其并发症的诊断价值，并评估其在康复锻炼指导中的应用效果。方法 选取2020年1月至2022年1月本院收治的OP及其并发症患者147例作为研究对象，男64例，女83例，年龄（66.49±5.58）岁。根据有无骨质疏松症并发症，将所纳受试者分成对照组（单纯OP患者73例）和观察组（OP合并并发症者74例），两组均予以DXA和腰椎CT检查，观察并比较两种检测方法诊断骨质疏松症及其并发症的患病率。将观察组74例患者随机分为DXA指导组（37例）和CT指导组（37例），制定个性化锻炼方案并进行6个月随访，评估锻炼依从性和效果。结果 ①观察组的L2～L4骨密度均值、髋部T值、腰椎最低T值均低于对照组，L1椎体CT值显著低于对照组，差异有统计学意义（P＜0.05）。②对照组和观察组的腰椎（L2-4）DXA的T值、骨密度均值与L1椎体CT值均呈正相关（P＜0.001）。③观察组DXA检测结果显示，轻度骨质疏松、中度骨质疏松、重度骨质疏松各59.46%、22.97%、17.57%，腰椎CT检测结果显示，骨质疏松、骨量减少、骨量正常各56.76%、27.03%、16.22%，DXA与腰椎检测结果Kappa=0.721，提示两者的一致性较高。④在观察组中，CT指导组患者锻炼总依从性显著高于DXA指导组（86.5% vs 75.7%，P＜0.05）。⑤6个月后CT指导组骨密度改善更明显，腰椎T值从-2.33±1.25提高到-2.15±1.19，DXA指导组从-2.37±1.21提高到-2.26±1.18（组间改善幅度P＜0.05）。⑥CT指导组疼痛缓解效果更佳，VAS评分从（5.72±1.85）分降至（3.18±1.41）分，DXA指导组从5.81±1.92降至3.76±1.58（P＜0.05）。⑦患者满意度CT指导组显著高于DXA指导组（4.35±0.62 vs 4.08±0.71，P＜0.05）。结论 在OP及其并发症的临床检测用DXA与腰椎CT检测结果准确性均高，腰椎CT更适合用于OP及其合并症的检测。在OP并发症患者中，基于CT诊断制定的个性化锻炼方案在提高依从性、改善骨密度和缓解疼痛方面均优于DXA指导方案。
Abstract:
Objective To investigate the diagnostic value of dual-energy X-ray absorptiometry (DXA) and lumbar spine CT in the diagnosis of osteoporosis (OP) and its complications, and to evaluate their effectiveness in guiding rehabilitation exercises. Methods A total of 147 patients with osteoporosis (OP) admitted to our hospital between January 2020 and January 2022 were selected as study subjects, including 64 men and 83 women, with a mean age of (66.49±5.58) years. Based on the presence or absence of osteoporosis complications, the enrolled subjects were divided into a control group (73 patients with uncomplicated OP) and an experimental group (74 patients with OP and complications). Both groups underwent DXA and lumbar spine CT examinations to observe and compare the prevalence of osteoporosis and its complications diagnosed by the two methods. The 74 patients in the experimental group were randomly divided into a DXA-guided group (37 patients) and a CT-guided group (37 patients). Personalized exercise regimens were developed, and participants were followed up for 6 months to assess exercise adherence and efficacy. Results ①The mean bone mineral density at L2-L4, hip T-score, and lowest lumbar T-score in the experimental group were all lower than those in the control group, and the CT value of the L1 vertebra was significantly lower than that in the control group, with statistically significant differences (P<0.05). ② In both the control and experimental groups, the DXA T-scores and mean bone mineral density of the lumbar spine (L2-L4) were positively correlated with the CT values of the L1 vertebra (P<0.001). ③DXA results in the experimental group showed that 59.46%, 22.97%, and 17.57% of patients had mild, moderate, and severe osteoporosis, respectively. Lumbar spine CT results showed that 56.76%, 27.03%, and 16.22% of patients had osteoporosis, osteopenia, and normal bone mass, respectively. The Kappa coefficient between DXA and lumbar spine CT results was 0.721, indicating a high degree of consistency between the two. ④In the experimental group, overall exercise adherence was significantly higher in the CT-guided group than in the DXA-guided group (86.5% vs. 75.7%, P<0.05). ⑤After 6 months, the CT-guided group showed more pronounced improvements in bone density, with lumbar spine T-scores increasing from -2.33±1.25 to -2.15±1.19, while the DXA-guided group improved from -2.37±1.21 to -2.26±1.18 (P<0.05 for the difference in improvement between groups). ⑥ Pain relief was more pronounced in the CT guidance group, with VAS scores decreasing from 5.72±1.85 to 3.18±1.41, while in the DXA guidance group, scores decreased from 5.81±1.92 to 3.76±1.58 (P<0.05). ⑦ Patient satisfaction was significantly higher in the CT-guided group than in the DXA-guided group (4.35 ± 0.62 vs. 4.08 ± 0.71, P<0.05). Conclusion Both DXA and lumbar CT offer high accuracy in the clinical detection of OP and its complications; however, lumbar CT is more suitable for the detection of OP and its complications. Among patients with OP complications, personalized exercise programs based on CT-guided diagnosis were superior to DXA-guided programs in terms of improving adherence, enhancing bone density, and alleviating pain.

备注/Memo

备注/Memo:
基金项目：河北省2017年度医学科学研究重点课题计划（20171315）
更新日期/Last Update: 2026-05-19