中文摘要：

目的 探讨中国男性骨质疏松股骨颈骨折患者股骨头松质骨微结构的区域差异,明确微结构差异对股骨颈骨折的影响.方法 18例中国男性股骨颈骨折患者股骨头标本,根据脆性骨折分为骨质疏松骨折（11例）和外伤骨折（7例）2组.定位标记后取6 mm×6 mm×7mm的松质骨骨块9块,其中1块为主应力区标本,其他8块为非主应力区标本.行显微CT扫描,测量各骨块三维骨微结构参数.用t检验分析两组主应力区、非主应力区和所有标本平均值松质骨的微结构参数.结果 骨质疏松骨折组,非主应力区与主应力区相比,体积骨密度[非主应力区为（182.15 ±66.00）mg/mm^3,主应力区为（223.97±70.92）mg/mm^3,t=3.041]、组织骨密度[非主应力区为（538.76±64.72）mg/mm^3,主应力区为（580.01±63.86）mg/mm^3,t=3.160]、骨体积分数[非主应力区为（0.22±0.06）%,主应力区为（0.26±0.07）%,t=2.821]、骨小梁厚度[非主应力区为（161.07±42.75）μm,主应力区为（205.47±74.44）μm,t=3.233]显著下降,骨表面体积比[非主应力区为（13.75 ±2.55）mm^-1,主应力区为（12.28±2.70）mm^-1,t=-2.777]显著增加,差异均有统计学意义（P值均〈0.05）.在非主应力区,骨质疏松骨折组与外伤骨折组比较,体积骨密度[外伤骨折组为（248.05±105.48）mg/mm^3,t=-3.598]、组织骨密度[外伤骨折组为（570.54 ±100.32）mg/mm^3,t=-2.108]、骨体积分数[外伤骨折组为（0.28±0.12）%,t=-3.466]、骨小梁厚度[外伤骨折组为（200.31±96.63）μm,t=-2.866]、骨小梁数量[骨质疏松骨折组为（1.46±0.23）个/mm3,外伤骨折组为（1.57±0.29）个/mm^3,t=-2.396]显著下降,骨小梁间隔[骨质疏松骨折组为（780.82±144.85）μm,外伤骨折组为（653.09±119.64）μm,t=5.470]、各向异性度（骨质疏松骨折组为1.57±0.20,外伤骨折组为1.47±0.18,t=2.930）显著增加,差异有统计学意义（P值均〈0.05）.所有18个标本主应力区骨小梁厚度[（19

英文摘要：

Objective The aim of this study was to investigate the femoral head trabecular heterogeneity in Chinese male patients with osteoporotic fracture and their effects on osteoporotie fracture.Methods Human femoral heads were obtained from 11 male osteoporotie fracture （OP） patients ranged from 51 to 82 years old [average age （65±9 ） years old], and 7 male trauma （ TM ） patients ranged from 46 to 75 years old [average age （61±11 ） years old] who underwent total hip arthroplasty within two hours after either osteoporotic or trauma hip fracture.The OP was defined as having a fragility fracture.After laying femoral head as living body position and locating mark, nine trabecular specimens were obtained from femoral heads, each of 6 mm × 6 mm× 7 mm.The cortical shell was not included in each specimen.One cube was selected as the primary compressive trabecular region and the other 8 specimens as non-primary compressive trabecular region.These cubes were scanned using high-resolution microcomputed tomography scanner （μCT）.After scanning, the data of total cubes, primary compressive trabecular region and noncompressive trabecular region were used for analysis by t test.Results In OP group volumetric bone mineral deosity（vBMD） [（ 182.15±66.00） mg/mm^3 vs （223.97±70.92） mg/mm^3, t =3.041], tissue bone mineral density （tBMD） [（538.76±64.72） mg/mm3 vs （580.01±63.86 ） mg/mm^3, t = 3.160],bone volume fraction （TV/BV） [（0.22 ± 0.06） % vs （0.26 ± 0.07 ） %, t = 2.821], trabecular thickness （Tb.Th.） [（ 161.07 ±42.75 ） μm vs （ 205.47 ± 74.44 ） μm, t = 3.233] were significantly decreased while bone surface/bone volume （ BS/BV ） [（ 13.75 ± 2.55 ） mm^-1 vs （ 12.28 ± 2.70 ） mm^-1, t =-2.777] was significantly increased in the non-primary compressive trabecular region than that in the primary compressive trabecular region （ P 〈 0.05 ）.vBMD [（ 182.15 ± 66.00） mg/mm^3 vs （ 248.05 ±105.48） mg/mm3, t = - 3.598], tBMD [（538.76 ± 64.