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| FRAX工具不同方法评价北京地区中老年骨质疏松骨折风险的回顾性研究 |
| A retrospective study on the evaluation of osteoporotic fracture risk in middle-aged and elderly patients in Beijing by different methods of FRAX tools |
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| DOI：10.3969/j.issn.1006.7108.2019.03.004 |
| 中文关键词: FRAX DXA 桡骨远端骨密度 股骨颈骨密度 骨质疏松症 |
| 英文关键词:FRAX DXA distal humeral bone mineral density femoral neck bone mineral density osteoporosis |
| 基金项目:北京市科技计划课题《大兴区关于“北京市城镇居民骨质疏松症社区规范化管理标准”等相关技术的推广应用研究》（Z151100004015233）；国际课题《IOF对骨量减少人群骨折风险评估(FRAX)前瞻性研究》（IOFCJO-D001） |
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| 中文摘要: |
| 目的 通过应用FRAX骨折风险评估系统联合桡骨远端1/3处骨密度、股骨颈骨密度，探讨FRAX联合不同部位骨密度后分析10年内发生全身骨折风险的概率。方法 回顾性分析7488例分别接受DXA桡骨远端、股骨颈检查的体检人群，将桡骨远端骨密度、股骨颈骨密度分别输入FRAX骨折风险评估系统，分析比较两种方法计算出的未来10年骨折风险概率随年龄、性别的变化趋势，采用两独立样本t检验比较两者间的差异。结果 FRAX联合Hologic法股骨颈骨密度及T指数桡骨远端骨密度所得到的未来10年骨折风险概率均整体表现为随年龄的增长呈增加趋势，其中Hologic股骨颈骨密度法女性骨折风险概率随年龄变化最为明显，且持续增加；60岁以后Hologic股骨颈骨密度法男性及T指数桡骨远端骨密度法女性随年龄增加幅度较缓慢；60岁以后男性T指数桡骨远端骨密度法骨折风险概率随年龄增长轻度下降；两种方法骨折风险概率的增加幅度男性均小于女性，不论性别、年龄，骨折风险概率均值T指数桡骨远端骨密度法均小于Hologic股骨颈骨密度法。结论 FRAX分别联合桡骨远端骨密度及股骨颈骨密度评估未来10年骨折风险概率随年龄、性别变化趋势相仿，但采用桡骨远端骨密度的方法可能导致未来10年内骨折风险概率的低估，故不推荐采用，但测量桡骨远端骨密度的方法较股骨颈骨密度更加方便、快捷，故在日常工作中可作为对骨质疏松症的筛查手段之一。 |
| 英文摘要: |
| Objective To investigate the difference in the risk of systemic fracture within 10 years by applying the FRAX fracture risk assessment system combined with bone mineral density (BMD) of the distal 1/3 of the humerus and the femoral neck. Methods A retrospective analysis was performed on 7488 patients undergoing DXA neck examination of the distal humerus and the femurs. BMD of the distal humerus and the femoral neck were assigned to the FRAX fracture risk assessment system, respectively. The 10-year fracture risk with age and gender calculated by these two methods was compared and analyzed. Two independent sample t test was used to compare the differences. Results The 10-year fracture risk obtained by FRAX combined with Hologic BMD of the femoral neck method and T index of the distal humerus increased with age. The increase was more obvious and continuous in females. After 60 years old, the increase slowed in males with Hologic BMD of the femoral neck method and in females with the T index of the distal humerus method. Also, the fracture risk decreased slightly in males with the T index of the distal humerus method after 60 years old. The increase in the probability of fracture by both methods was lower in men than in women. Regardless of gender and age, the mean fracture risk was lower in T index of the distal humerus method than in Hologic BMD of the femoral neck method. Conclusion The trend of 10-year fracture risk of different age and gender is similar with the assessment by FRAX tool combined with BMD of the distal humerus or combined with BMD of femoral neck. However, the use of distal humerus BMD method may lead to underestimate of the fracture risk within the next 10 years. Therefore, it is not recommended. It is more convenient and faster to measure BMD of the distal humerus than BMD of the femoral neck. It can be used as a screening method for osteoporosis in daily work. |
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