OSTEOPOROSIS AFTER SPINAL-CORD INJURY
OSTEOPOROSIS AFTER SPINAL-CORD INJURY
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DOI：
10.1002/jor.1100100309
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发表时间：
1992-05-01
影响因子：
2.8
通讯作者：
WEINSTEIN, DA
中科院分区：
文献类型：
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作者：
GARLAND, DE;STEWART, CA;WEINSTEIN, DA
双光子吸收测定法表征了年龄 < 40 岁男性完全外伤性截瘫和四肢瘫痪脊髓损伤后的骨质流失。 对 55 名受试者的不同区域的总骨量和膝关节骨矿物质密度 (BMD) 进行了测量。 三个不同的人群被分为四组：10 名对照组（健康、年龄匹配）； 25 名急性损伤（伤后 114 天），其中 12 名在伤后 16 个月重新检查；和 20 种慢性病（受伤后 > 5 年）。 手臂、骨盆、腿部、股骨远端和胫骨近端各组之间的骨量矿物质存在显着差异（p < 0.0001），而头部或躯干没有差异。 事后分析表明，16 个月时急性损伤和慢性损伤之间没有差异。 截瘫和四肢瘫痪受试者仅在手臂和躯干上存在显着差异，但在骨盆及以下部位高度相似。 在重伤者中，骨盆上方出现轻微但统计上不显着的反弹。 回归技术证明骨盆以下的骨质出现早期、快速、线性（p < 0.0001）下降。 除头骨外，整个骨骼都会发生骨矿物质流失。 大多数骨质流失发生在骨盆下方，速度很快。 16 个月后，体内平衡达到原始骨量的三分之二，接近骨折阈值。
Dual-photon absorptiometry characterized bone loss in males aged < 40 years after complete traumatic paraplegic and quadriplegic spinal cord injury. Total bone mass of various regions and bone mineral density (BMD) of the knee were measured in 55 subjects. Three different populations were partitioned into four groups: 10 controls (healthy, age matched); 25 acutely injured (114 days after injury), with 12 reexamined 16 months after injury; and 20 chronic (> 5 years after injury). Significant differences (p < 0.0001) in bone mass mineral between groups at the arms, pelvis, legs, distal femur, and proximal tibia were found, with no differences for the head or trunk. Post hoc analyses indicated no differences between the acutely injured at 16 months and the chronically injured. Paraplegic and quadriplegic subjects were significantly different only at the arms and trunk, but were highly similar at the pelvis and below. In the acutely injured, a slight but statistically insignificant rebound was noted above the pelvis. Regression techniques demonstrated early, rapid, linear (p < 0.0001) decline of bone below the pelvis. Bone mineral loss occurs throughout the entire skeleton, except the skull. Most bone loss occurs rapidly and below the pelvis. Homeostasis is reached by 16 months at two thirds of original bone mass, near fracture threshold.