中国骨质疏松杂志

各地区FRAX干预阈值在无锡地区骨质疏松防治中的临床应用

The clinical value of the different intervention cut-off point of FRAX in Wuxi region

DOI：10.3969/j.issn.1006.7108.2016.04.015

英文关键词:Osteoporosis FRAX Intervention cut-off point

基金项目:

作者	单位
李燕云1 丁绍红1 高远1 唐伟2*	1.东南大学医学院附属江阴医院内分泌科，江阴214400 2.江苏省老年医院内分泌科，南京210024

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中文摘要:

目的分析各地区FRAX干预阈值与BMD之间的关系，探讨各地区FRAX干预阈值在无锡地区临床应用中的价值。方法收集本院职工体检资料，通过HOLOGIC双能X线（DXA)骨密度仪测定骨密度，同时采用FRAX系统评估患者10年骨质疏松性骨折的发生风险。以DXA测量结果为金标准，判断各FRAX干预阈值在实际临床工作中的应用价值；通过多元线性回归分析判断年龄、性别、身高、体重对FRAX结果的影响。结果美国干预阈值与DXA相比，FRAX的敏感性为3. 51%、特异性为99. 79%，阳性预测值为66. 67% ,阴性预测值为89. 95% ；英国干预阈值与DXA相比，FRAX敏感性为3. 51%、特异性98.58% ,阳性预测值为22. 22%、阴性预测值为89. 83% ;日本干预阈值与DXA相比，FRAX敏感性8.77%、特异性98. 38% ,阳性预测值38. 46%、阴性预测值90. 32% ;我国乌鲁木齐市的干预阈值与DXA相比，敏感性5. 26%、特异性97. 97% ,阳性预测值23.08%、阴性预测值89.M%。年龄、股骨颈T值对FRAX结果影响最大。结论各地区FRAX干预阈值在无锡地区骨质疏松诊疗工作中的应用意义不大，应建立适合无锡地区的干预阈值。

英文摘要:

Objective To discuss the association between the different cut-off point of FRAX and BMD, and the clinical value in Wuxi region. Methods We collected the medical examination of hospital staff, we measured the BMD through DXA, simultaneously we evaluated the 10-year risk of bone fragility by FRAX(Fracture Risk Assessment Tool), The gold standard is BMD,We explored age, sex, height, weight to affect the results of FRAX by multiple linear regression analysis. Results Compared with DXA, the cut-off point of America,the Sensitivity is 3. 51 %，the Specific is 99. 79% , the positive predictive value is 66. 67%，the negative predictive value is 89. 95% . Then England, the Sensitivity is 3.51% , the Specific is 98. 58%，the positive predictive value is 22. 22% , the negative predictive value is 89. 83% ；Compared with Japan,the Sensitivity is 8. 77%，the Specific is 98. 38% ,the positive predictive value is 38.46%，the negative predictive value is 90. 32% . then Urumqi the Sensitivity is 5.26% , the Specific 97. 97% , the positive predictive value is 23. 08% ,the negative predictive value is 89. 94% .The greatest impact on the FRAX results is age and femoral neck T-score. Conclusion The clinical value of the different intervention cut-off point of FRAX in Wuxi region is meaningless, we should establish an appropriate cut-off point of Local region.

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