儿科密度计:Z分数调整是否在所有情况下都是必要的?
Berta Magallares1,2,3,4, Jorge Malouf5, Helena Codes-Méndez1,3
1Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Frontiers in endocrinology
|April 24, 2025
概括
根据身高与年龄的Z-score (HAZ) 调整对于准确评估儿童的骨矿物质密度 (BMD) 至关重要. 这种调整可以提高儿童患者低骨矿物密度 (LBMD) 的诊断准确性,无论身高如何.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 放射学 放射学是一门学科.
- 骨健康 骨健康 骨健康
背景情况:
- 国际临床密度学会建议在患有生长问题的儿童中调整骨矿物质密度 (BMD) Z-分数.
- 所有儿科患者的身高年龄Z-score (HAZ) 调整的必要性尚不清楚.
研究的目的:
- 为了确定所有接受 BMD 评估的儿童是否需要 HAZ 调整.
- 检查大量儿科队列中未调整和HAZ调整的Z分数的变异性.
主要方法:
- 评估了103名儿科患者 (≤20岁) 接受腰椎和全身DXA扫描.
- 使用泽梅尔公式计算HAZ.
- 与未调整和HAZ调整的BMDZ分数和LBMD的诊断标准进行比较.
主要成果:
- 在调整和未调整的Z分数之间观察到7%的诊断差异率.
- HAZ调整使LBMD的患病率从8.2%降至6.4% (腰椎) 和10.5%降至7.2% (全身).
- 5%的患者在调整后不再符合LBMD标准,而2%的患者在调整后才符合标准.
结论:
- 对Z分数的HAZ调整对于改善儿科患者的诊断准确性是有价值的.
- 密度计尺寸调整可能有利于所有儿科患者,而不仅仅是身高矮或生长迟缓的儿童.
- 尺寸调整对于身高范围的上端儿童尤其重要,以避免掩盖LBMD诊断.
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