FRAX评估RA患者骨质疏松性腰椎骨折风险及相关因素分析  

Evaluation of the risk of osteoporotic lumbar vertebra fractures using FRAX in RA patients and analysis of related factors

作　　者：谢勇[1] 林红晓[2] XIE Yong;LIN Hong-xiao(West China Hospital of Sichuan University,Chengdu,Sichuan,610041,China;the First People＇sHospital of Lianyungang,Lianyungang,Jiangsu,222000,China)

机构地区：[1]四川大学华西医院,四川成都610041 [2]连云港市第一人民医院,江苏连云港222000

出　　处：《颈腰痛杂志》2018年第6期683-686,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨骨折危险性评估工具(fracture risk assessment tool,FRAX)评估类风湿关节炎(rheumatoid arthritis,RA)患者骨质疏松性腰椎骨折风险的应用效果,并进行骨折风险相关因素分析。方法纳入2016-01-2018-01于我院治疗的130例RA患者以及100例年龄、性别配对的正常体检人员,分别设为RA组与对照组。采用双能X线骨密度仪测定腰椎L_1～S_1骨密度;采用FRAX评估,调查患者年龄、性别、体重、身高以及世界卫生组织(WHO)推荐使用的7个骨折预测因子,评估RA患者骨质疏松性腰椎骨折风险,按骨折风险<10%、≥10%分为低风险组与中高风险组,采用单因素及多因素Logistic回归分析探讨RA患者骨质疏松性腰椎骨折风险的独立影响因素。结果 RA组L1～S1骨密度均显著低于对照组,差异具有统计学意义(P<0.05);RA组10年腰椎骨折风险为(9.45±3.31)%,显著高于对照组的(2.75±0.43)%;差异具有统计学意义(P<0.05);高风险组与低风险组年龄、性别、父母骨质疏松症骨折史、吸烟史、激素使用时间、RA病程差异具有统计学意义(P<0.05);多因素分析显示:年龄≥70岁、激素使用时间>1年、女性,是RA患者骨质疏松性腰椎骨折风险的独立影响因素。结论 RA患者腰椎骨密度显著低于正常人群,10年骨折风险显著上升,年龄>70岁、女性、激素使用时间>1年均可增加腰椎骨折风险。Objective To investigate the application effect of fracture risk assessment tool（FRAX） in the evaluation of the risk of osteoporotic lumbar fractures in patients with rheumatoidarthritis（RA）, and to analyze the related risk factors of fracture. Methods A total of 130 patients withRA treated in our hospital from January 2016 to January 2018 and 100 healthy people with age andgender matched were selected in this research. They were divided into the RA group and the controlgroup. The bone density of lumbar spine L1 -S1 was measured by dual-energy X-rays densitometer.FRAX was used to evaluate the risk of osteoporotic lumbar vertebrae fracture in RA patients byinvestigating the age, sex, weight, height and 7 fracture predictors recommended by WHO. Accordingto risk 〈10% and ≥10%, they were divided into the low-risk group and the middle-high-risk group.The independent influencing factors of the risk of osteoporotic lumbar fracture in patients with RAwere discussed by univariate and multivariate Logistic regression analysis. Results The bone densityof L1-S1 in the RA group was significantly lower than that in the control group, and the difference wasstatistically significant （P〈0.05）. The risk of lumbar fracture for ten years in the RA group was （9.45±3.31）%, which was significantly higher than that in the control group[（2.75±0.43）%], the difference wasstatistically significant （P〈0.05）. There were significant differences in age, gender, parental osteoporosisfracture history, smoking history, hormone use time and RA course score between the high-risk groupand the low-risk group （P〈0.05）. There were no significant differences in drinking history, combinedchronic disease, and fracture history （P〉0.05）. Multivariate Logistic regression analysis showed thatage≥70, hormone use time 〉1 year and female were the independent risk factors of the risk ofosteoporotic lumbar fractures in RA patients. Conclusion The bone density of lumbar spine in RApatients was significantly lower tha

关 键 词：FRAX RA 骨质疏松性腰椎骨折 骨折风险 相关因素 

分 类 号：R274.1[医药卫生—中医骨伤科学]