应用FRAX工具评估类风湿关节炎患者骨质疏松性骨折风险  

Application of FRAX tool to assess the risk of osteoporotic fractures in patients with rheumatoid arthritis in China

作　　者：李旭艳 董红宇 LI Xuyan;DONG Hongyu(Department of Rheumatology and Immunology, Shijingshan Teaching Hospital, Capital Medical University, Beijing Shijingshan Hospital, Beijing 100049, China)

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院风湿免疫科,北京100049

出　　处：《中国骨质疏松杂志》2021年第10期1476-1480,1490,共6页Chinese Journal of Osteoporosis

基　　金：首都卫生发展科研专项项目(首发2016-3-7091)。

摘　　要：目的应用骨折风险评估工具(FRAX)评估类风湿关节炎(RA)患者10年内主要骨折及髋部骨折的发生率及相关危险因素。方法回顾性分析2013年至2019年于北京市石景山医院风湿免疫科就诊且资料完整的RA患者206例,应用FRAX工具评估患者10年内主要骨折及髋部骨折发生风险。结果①病程长、绝经时间长、病情活动度高及曾应用激素的RA患者10年内主要骨折及髋部骨折风险更高;②糖皮质激素日剂量及使用时间与RA患者10年内主要骨折及髋部骨折风险无明显相关性;③RF及抗CCP阳性与阴性患者间10年骨折发生风险无明显差异。结论绝经时间长、病程长、病情活动度高的RA患者骨质疏松性骨折发生风险更高,而FRAX模型中并未考虑到这些因素,因此,可能低估了这部分患者的骨折风险,临床工作中对这部分患者更应该防治骨质疏松及骨质疏松性骨折。Objective To evaluate the incidence and risk factors of major fractures and hip fractures in patients with rheumatoid arthritis(RA)over a 10-year period using the fracture risk assessment tool(FRAX).Methods A retrospective analysis was performed on 206 RA patients with complete data who visited the department of rheumatology,shijingshan hospital,Beijing from 2013 to 2019.FRAX was used to assess the risk of major fractures and hip fractures in the patients within 10 years.Results(1)RA patients with a long course of disease,a long duration of menopause,a high degree of activity and hormone use had a higher risk of major fracture and hip fracture within 10 years.(2)There was no significant correlation between the daily dose and duration of glucocorticoids and the risk of major fractures and hip fractures in RA patients within 10 years.(3)There was no significant difference in 10-year fracture risk between RF and ccp-positive and ccp-negative patients.Conclusion The risk of osteoportic fracture is higher in RA patients with long menopausal duration,long course of disease and high activity.However,FRAX model does not take these factors into account,which may underestimate the risk of fracture in these patients,and it is more important to prevent and treat osteoporosis and osteoportic fracture in clinical work.

关 键 词：类风湿关节炎 骨质疏松性骨折 FRAX 

分 类 号：R593.22[医药卫生—内科学]