目的 考虑到肌肉通过力学对骨量变化的影响,我们调查分析老年髋部骨折女性肌肉组织变化与骨密度之间的关系。方法 选取79例老年髋部骨折女性作为骨折组,45例体检人员作为对照组,进行调查分析全身肌肉含量、全身脂肪含量、躯干肌肉含量、躯干脂肪含量、上肢肌肉含量、上肢脂肪含量、下肢肌肉含量、下肢脂肪含量；腰椎1-4椎体、股骨颈、髋关节及全身骨密度。结果 骨折组老年女性中全身、上肢、下肢肌肉含量及脂肪含量、躯干脂肪含量、骨骼肌肌量相对指数(SMI)和全身骨密度显著低于对照组(P ＜0.05)。骨折组老年女性肌少症检出率明显增高(60.76% VS 42.22%)。粗隆间骨折女性患侧股骨颈骨密度明显低于健侧(0.490±0.092 VS 0.613±0.099)。Logistic回归分析发现骨折组人群SMI与年龄呈负相关,与体重指数(BMI)、股骨颈骨密度及全身骨密度呈正相关。结论 老年髋部骨折女性肌少症检出率明显增加、其SMI和股骨颈骨密度及全身骨密度显著相关,在老年人群骨质疏松性骨折防治中应高度重视肌少症。

Objective To investigate the correlation between the change of muscle tissue and bone density in elderly women with hip fracture. Methods 79 elderly patients with hip fracture were selected as the fracture group and 45 physical examination personnel as the control group. Results Muscle content and fat content of whole body, upper limb and lower limb, trunk fat content, relative index of skeletal muscle mass (SMI) and bone mineral density in the fracture group were significantly lower than those in the control group (P < 0.05). The incidence rate of sarcopenia in fracture population was higher than that in control group (60.76% PS 42.22%). Bone mineral density of femoral neck of the affected side was significantly lower than that of the intact side in women with intertrochanteric fractures (0.490±0.092 VS 0.613±0.099). Logistic analysis found that SMI in elderly women with hip fracture was negatively correlated with age, and positively correlated with body mass index (BMI), femoral neck bone density and systemic bone density. Conclusion The rate of sarcopenia was significantly higher in elderly patients with hip fracture, and SMI was closely related to femoral neck bone density and systemic bone density. Therefore, sarcopenia should be highly emphasized in the prevention and treatment of osteoporotic fracture in elderly people.