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| 骨折风险评估工具(FRAX)对40岁以上2型糖尿病患者的骨折风险预测价值分析 |
| Predictive value of fracture risk assessment tool (FRAX) in patients with type 2 diabetes mellitus aged over 40 years old |
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| DOI：10.3969/j.issn.1006-7108.2019.06.008 |
| 中文关键词: 糖尿病，2型 骨折风险预测 骨折风险评估工具 骨密度 |
| 英文关键词:diabetes mellitus, type 2 fracture risk prediction fracture risk assessment tool bone mineral density |
| 基金项目:江苏省“六大人才高峰”高层次人才基金项目(WSW-169) |
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| 中文摘要: |
| 目的 研究探讨骨折风险评估工具（fracture risk assessment tool，FRAX）对40岁以上2型糖尿病患者的骨折风险预测价值。方法 选择2016年1月至2017年12月就诊于我院的300例40岁以上2型糖尿病患者为研究对象，调查了解研究对象的基本信息，再对患者进行骨密度检查。将研究数据录入至FRAX问卷中，分别计算未录入股骨颈骨密度数据的髋部骨折风险系数（FRAX）和录入股骨颈骨密度数据后的髋部骨折风险系数（FRAX-BMD），比较患者的FRAX与FRAX-BMD。将髋部骨折风险系数≥3%作为治疗切点，统计其治疗建议，以FRAX-BMD为参照，计算FRAX对髋部骨折治疗建议的灵敏度、特异度、准确率，分析其一致性，再将2型糖尿病患者分为治疗建议相同组、治疗建议不同组，比较治疗建议相同组与治疗建议不同组的临床资料。结果 2型糖尿病患者的FRAX与FRAX-BMD比较，差异无统计学意义（P＞0.05）。以FRAX-BMD为参照，FRAX对2型糖尿病患者髋部骨折治疗建议的灵敏度、特异度、准确率分别为96.76%、96.23%、96.67%，而经一致性分析，FRAX与FRAX-BMD对2型糖尿病患者髋部骨折治疗建议的一致性良好（Kappa=0.835）。治疗建议相同组的年龄小于治疗建议不同组（P＜0.05），其股骨颈骨密度高于治疗建议不同组（P＜0.05），其男性患者多于治疗建议不同组（P＜0.05）。结论 在40岁以上2型糖尿病患者中，采用骨折风险评估工具对患者髋部骨折风险的预测准确性较高，尤其是年龄较小、骨密度值较大、男性等患者。 |
| 英文摘要: |
| Objective To study the predictive value of fracture risk assessment tool (FRAX) in patients with type 2 diabetes aged over 40 years. Methods From January 2016 to December 2017, 300 patients of our hospital with type 2 diabetes and aged over 40 years were selected. The basic information of the subjects was investigated and bone mineral density (BMD) was examined. The study data were inputted into FRAX questionnaire to calculate the hip fracture risk coefficient without femoral neck BMD data (FRAX) and the hip fracture risk coefficient with femoral neck BMD data (FRAX-BMD), respectively. The FRAX and FRAX-BMD of the patients were compared. Hip fracture risk coefficient ≥ 3% was taken as the treatment point, and the treatment recommendation was counted. The sensitivity, specificity and accuracy of FRAX for hip fracture treatment were calculated with FRAX-BMD as the reference, and the consistency was analyzed. Patients with type 2 diabetes mellitus were divided into two groups: the same treatment recommendation group and the different treatment recommendation group; the clinical data of the two groups were compared. Results There was no significant difference between FRAX and FRAX-BMD in patients with type 2 diabetes mellitus (P>0.05). Using FRAX-BMD as the reference, the sensitivity, specificity and accuracy of FRAX for the treatment recommendation of hip fracture in type 2 diabetic patients were 96.76%, 96.23% and 96.67%, respectively. The consistency between FRAX and FRAX-BMD in the treatment recommendation of hip fracture in type 2 diabetic patients was good (Kappa=0.835). The same treatment recommendation group had younger age (P<0.05), higher bone mineral density of femoral neck (P<0.05), and more male patients (P<0.05) compared with the different treatment recommendation group. Conclusion In patients with type 2 diabetes mellitus aged over 40 years, the accuracy of predicting hip fracture risk by using fracture risk assessment tool is high, and the fracture risk can be predicted accurately, especially in those of younger age, higher bone mineral density and male gender. |
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