骨折风险评估工具(FRAX~)对绝经后低骨量女性骨折的预测价值  

Fracture predictive values of FRAX~ for low bone mass of postmenopausal women

作　　者：朱再胜[1] 章振林[2] 

机构地区：[1]浙江温州医学院附属第一医院老年病科,温州325000 [2]上海交通大学附属第六人民医院骨质疏松科骨代谢病和遗传研究室,上海200233

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2013年第3期213-218,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：上海市科委重大科技专题攻关专项(10D1950100);国家自然科学基金(81070692;81170803);上海市卫生系统新百人优秀学科带头人培养计划(XBR2011014)

摘　　要：目的评估骨折风险评估工具（FRAX）对绝经后低骨量女性骨折的预测价值。方法收集绝经后低骨量上海女性769人，记录所有受试者年龄、身高、体重、脆性骨折史、父母脆性骨折史、口服激素史、类风湿关节炎史、吸烟史、饮酒史，腰椎1-4（1-4）和左侧股骨颈骨密度（bone mineral density，BMD）。应用骨折风险评估工具（FRAX）中国模式计算受试个体的10年骨折概率，筛选达到骨质疏松性骨折高危患者诊断标准的个体。按年龄将受试者分为50～59岁组，60～69岁组，70～79岁组和80—90岁组，分析不同年龄组10年髋部骨折概率和10年主要骨质疏松性骨折概率。结果受试者中无人达到骨质疏松性骨折高危患者诊断标准。10年髋部骨折概率为0．40±0．26（范围：0～2．2）；10年主要骨质疏松性骨折概率为2．27±0．62（范围：1．0～4．9）。10年髋部骨折概率随着年龄增长而升高，各年龄组间差异有统计学意义（P〈0．01）。10年主要骨质疏松性骨折概率在50至70岁期间，并随年龄增长而升高，随后随年龄增长逐渐下降，各年龄组差异有统计学意义（P〈0．01）。结论FRAX中国模式运算结果低估了绝经后低骨量上海女性10年骨折概率，尤其是70岁以后10年主要骨质疏松性骨折概率；应进一步探讨FRAX中国模式对绝经后低骨量女性骨折的预测价值。Objective To evaluate the fracture predictive values of fracture risk assessment tool FRAX for the low bone mass of postmenopausal women. Methods 769 low bone mass of postmenopausal women in Shanghai were retrospectively collected. All cases had the data of the age, height, weight, history of fragility fracture, parental history of fragility fractures, oral steroid history, history of rheumatoid arthritis, smoking history, history of alcohol consumption, L1-4 and left femoral neck bone mineral density （BMD）. Each individual 10-year fracture probability was calculated by fracture risk assessment tool FRAX of Chinese model. Individuals which reached the diagnostic criteria of high risk of osteoporotic fracture were screened. The 10-year probabilities of a hip fracture and a major osteoporotic fracture by age were divided into four groups, 50 to 59 group, 60 to 69 group, 70 to 79 group and 80 to 90 group. The 10-year probability of osteoporosis fracture was analyzed. Results None achieved the diagnostic criteria of high risk of osteoporotie fracture. The 10-year probability of major osteoporotic fracture was 2.27 ±0. 62 （range： 1.0 -4. 9）. The 10-year probability of hip fracture was 0. 40 ±0. 26 （range： 0 -2. 2）. The 10-year probability of hip fracture were increased with age. There were significant differences in different ages （P 〈0. 01 ）. The 10-year probability of major osteoporotic fracture were in- creased with increasing age in a period of 50 -70 years of old and were decreased gradually in subsequently increasing age. There were statistically differences in all ages （P 〈 0. 01 ）. Conclusion The FRAX China model underestimated 10-year fracture probability of postmenopausal women with low bone mass in Shanghai, especially 10-year probability of a major osteoporotie fracture after 70-year-old.

关 键 词：低骨量 绝经后 骨折风险评估工具 

分 类 号：R681[医药卫生—骨科学]