目 的 通过对脊柱结核患者自身及健康人群骨密度的比较，探究脊柱结核与全身及病椎邻近椎体骨密度的相关性及其临床意义。 方 法 选取48例脊柱结核患者和48例健康人，行双能X射线骨密度仪测定两组样本脊柱正位(L1-L4)、双侧髋部骨密度；双螺旋CT对脊柱结核患者病变椎体(病椎)及其邻近的椎体（邻椎及远位椎体）进行骨密度测定，对照组也检测相应节段椎体骨密度，结果进行组间及椎体间比较。 结 果 （1）全身骨密度测定：两组间性别、年龄差异无统计学意义(P>0.05)，实验组腰椎正位（L1-L4）、双侧髋部骨密度低于对照组(P<0.05)，且实验组骨密度降低、骨质疏松发生率高于对照组(P<0.05)；（3）对两组局部骨密度测定:实验组病椎骨密度明显低于其邻近椎体及对照组同节段椎体，(P<0.05)；且实验组邻近椎体密度明显低于对照组同节段椎体，(P<0.05)；（4）样本中病椎自身骨密度降低的程度(百分数)高于邻近椎体及远位椎体骨密度降低程度(百分数)，(P<0.05)；而邻近椎体骨小梁骨密度降低程度(百分数)又高于远位椎体骨相应参数，(P<0.05)； 结 论 （1）脊柱结核可以导致全身骨密度降低，这与结核杆菌感染引起骨代谢异常从而导致骨密度降低有一定关系；（2）脊柱结核可以导致病椎及其邻近椎体骨密度减低，且邻近椎体(未被侵袭)骨密度降低程度高于远位椎体骨密度降低程度，可以总结出离病椎越远的椎体，骨密度降低程度越低，即骨密度变化越小、受影响越弱；而且部分病变椎体病灶周围可出现骨硬化、死骨形成而导致局部骨密度增高。

Objective By comparing the bone mineral density of patients with spinal tuberculosis and healthy people, explore the correlation between spinal tuberculosis and bone mineral density of the whole body and adjacent vertebrae and its clinical significance. Method 48 cases of spinal tuberculosis patients and 48 healthy normal persons were selected, and dual-energy X-ray bone densitometer was used to determine the orthotopic spine (L1-L4) and bilateral hip bone mineral density of the two groups of samples; double-helical CT analysis of the diseased vertebrae of patients with spinal tuberculosis The local bone density of the body (sick vertebra) and its adjacent vertebrae (adjacent vertebrae and distal vertebrae) were measured. The control group also tested the bone mineral density of the corresponding segments, and the results were compared between groups and vertebrae. Results (1) Measurement of whole body bone mineral density: There was no significant difference in gender and age between the two groups (P>0.05). The experimental group had lumbar vertebrae (L1-L4), bilateral femoral neck, femur triangle, femur trochanter and overall The hip bone density was lower than that of the control group (P<0.05), and the bone mineral density and osteoporosis rate in the experimental group were higher than those in the control group (P<0.05); (2) There were also some laboratory test results between the two groups(P<0.05); (3) Determination of local bone mineral density in the two groups: the vertebral body density of the experimental group was significantly lower than that of the adjacent vertebral body and the control group, and the difference was significant (P<0.05); The density of adjacent vertebral bodies was significantly lower than that of the control group, and the difference was significant (P<0.05). Some of the tuberculosis lesions had osteosclerosis and osteonecrosis at the edge of the vertebral body. The local bone mineral density of these parts was different. Increased, but the law has not been found in this experiment; (4) The degree of bone mineral density reduction (percentage) of the diseased vertebral body in the enrolled sample is higher than the decrease of the bone density of the adjacent vertebral body and the distal vertebral body (percentage), the difference is significant (P<0.05); adjacent to the vertebral body The degree of decrease in beam density (percentage) was higher than that of the distal vertebral body bone, and the difference was significant (P<0.05). Conclusions (1) Spinal tuberculosis may lead to a decrease in bone density, which is related to abnormal bone metabolism caused by Mycobacterium tuberculosis infection, which leads to a decrease in bone density; (2) Spinal tuberculosis may cause a decrease in bone density of the diseased vertebra and its adjacent vertebrae, and adjacent The reduction in bone density of the vertebral body (uninvaded) is higher than that of the distal vertebral body. It can be concluded that the farther the vertebral body is from the diseased vertebra, the lower the reduction in bone density, that is, the smaller the change in bone density and the impact The weaker; and some lesions around the vertebral body lesions may appear bone sclerosis, sequestrion formation, resulting in increased local bone density.