目的：探讨老年人髋部骨折与骨密度和跌倒的关系。方法2012年5月至2014年4月均因平地跌倒而导致股骨颈部和粗隆间骨折入住我院骨科治疗的患者共41例，男性9例，女性32例，年龄61～91岁，平均（79±8）岁，所有患者均为初次骨折且第一次接受双能X线骨密度检查。使用美国GE Lunar公司生产的Prodigy型双能X线吸收法（DXA），进行骨密度测量，分别测量正位腰椎腰1至腰4（L1～4）及健侧股骨颈部骨密度（BMD）。根据所测骨密度值和T值（T-Score）评分进行回顾性总结。结果老年人平地跌倒后发生髋部骨折，虽然股骨颈部骨密度值低于腰椎骨密度，但二部位骨密度值比较，差异无统计学意义（t=0.842，P＞0.05）。同样依据诊断骨质疏松的T值评分比较，股骨颈部T值评分低于腰椎T值评分，但二部位T值评分经统计学处理差异亦无统计学意义（t=1.893，P＞0.05）。结论老年人腰椎和股骨颈部任一部位骨量低下跌倒后均易发生骨质疏松性髋部骨折，因此，预防老年人髋部骨折，临床医师不仅要重视提升骨密度，更应注重对老年人进行防止跌倒知识的宣传教育，有效预防老年人骨质疏松性髋部骨折的发生。%Objective To analyse the relationship among the fracture in hip bone mineral density and falls. Methods Totally 41 patients[9 males, 32 females, ages 61-91, average age(79±8)] were selected who were in the hospital because of fracture in the neck of femur with falls from May 2012 to April 2014. All the patients were fracture and measured the bone mineral density (BMD) values by the first time. Use dual-energy X-ray absorptiometry named prodigy manufactured by GE Lunar, measured the BMD values including the lumbar spines (L1-4) and the neck of femur with health side. Retrospective analysis according to the BMD values and the T values. Results There were no significant difference comparing the BMD values between the neck of femur and the lumbar spines (t=0.842, P>0.05), compared with the T values, there were also no significant difference analysis between them (t=1.893, P>0.05). Conclusion The osteoporotic hip fracture easily occurs in old men with lower BMD in lumbar spines or in neck of femur. Therefore , prevention of hip fracture in the elderly, the clinician should not only attach importance to improve BMD, but also pay attention to the health education about how to avoid falling, so it can prevent the osteoporotic hip fracture effectively for old men.
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