亚洲骨质疏松自我评价工具对腹膜透析患者骨质疏松症预测效果的评价  

Evaluation of osteoporosis self-assessment tool for Asians on osteoporosis in peritoneal dialysis patients

作　　者：林力[1] 徐天[1] 李晓[1] 黄晓敏[1] 张春燕[1] 任红[1] LIN Li;XU Tian;LI Xiao;HUANG Xiaomin;ZHANG Chunyan;REN Hong(Department of Nephrology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏内科,上海200025

出　　处：《世界临床药物》2022年第6期752-756,共5页World Clinical Drug

摘　　要：目的观察亚洲骨质疏松自我评价工具(osteoporosis self-assessment tool for Asians,OSTA)对腹膜透析(peritoneal dialysis,PD)患者骨质疏松症(osteoporosis,OP)的预测效果。方法选取2013年1月至2014年1月于上海交通大学医学院附属瑞金医院肾脏内科门诊行PD及骨密度(bone mineral density,BMD)检测的患者145例,采用双能X射线吸收法评估OP发生率,采用OSTA指数三分类法将所有患者分为低危组(n=98)、中危组(n=33)及高危组(n=14)。比较3组患者BMD水平,评价OSTA的临床价值;比较OP患者与非OP患者血钙、血磷、血甲状旁腺激素(parathyroid hormone,PTH)水平差异;分析OP发生的独立危险因素。结果女性腰椎、髋关节OP发生率分别为14.81%、11.11%,骨量下降25.93%、48.15%;男性腰椎、髋关节OP发生率为2.44%、2.38%,骨量下降26.83%、20.24%。65岁以上患者腰椎、髋关节OP检出率分别为11.11%、13.33%,骨量下降33.33%、40.00%;65岁及以下患者腰椎、髋关节OP检出率分别为6.00%、2.00%,骨量下降22.00%、29.00%。女性和血PTH升高是发生OP的独立危险因素。跟据OSTA指数分组,低危组腰椎、髋关节OP检出率为5.10%、1.02%,中危组为12.12%、12.12%,高危组为14.29%、21.43%。结论PD患者OP和骨量下降发生率较高,尤其是女性患者。OP和骨量下降发生率随年龄增大而逐渐升高,血PTH控制不佳和女性是发生OP的独立危险因素。通过OSTA指数筛查PD患者OP发生效果不佳,在临床应用中有待进一步改良及验证。Objective To observe the predictive effect of osteoporosis self-assessment tool for Asians(OSTA)on osteoporosis(OP)in peritoneal dialysis(PD)patients.Methods A total of 145 PD patients who underwent bone mineral density(BMD)testing were selected from department of nephrology,Ruijin hospital affiliated to Shanghai Jiao Tong university school of medicine from January 2013 to January 2014.Dual energy X-ray absorptiometry was used to evaluate the incidence of OP in PD patients.PD patients were divided into low-risk group(n=98),medium-risk group(n=33)and high-risk group(n=14)by OSTA index.The BMD levels of the three groups were compared to evaluate the clinical value of OSTA.The levels of serum calcium,phosphorus and parathyroid hormone(PTH)were compared between OP patients and non OP patients,and the independent risk factors of OP were analyzed.Results The incidence of OP in female lumbar spine and hip were 14.81%and 11.11%,respectively,and the osteopenia were 25.93%and 48.15%.The incidence of OP in male lumbar spine and hip was 2.44%and 2.38%,and the osteopenia were 26.83%and 20.24%.The detection rates of OP in patients over 65 years old in lumbar and hip were 11.11%and 13.33%,respectively,and the osteopenia were 33.33%and 40.00%.The detection rates of OP in patients under 65 years old in lumbar and hip were 6.00%and 2.00%,respectively,and the osteopenia were by 22.00%and 29.00%.Female and elevated PTH are independent risk factors for OP.According to OSTA index grouping,the detection rates of OP in the lumbar and hip joint in the low-risk group were 5.10%and 1.02%,12.12%and 12.12%in the medium-risk group,14.29%and 21.43%in the high-risk group.Conclusion The incidence of OP and osteopenia in PD patients was higher,especially in female and the elderly.Poor control of PTH and the female were independent risk factors for OP.The screening effect of OP in PD patients by OSTA index is not effective,which needs to be further improved and verified in clinical application.

关 键 词：亚洲骨质疏松自我评价工具 腹膜透析 骨密度 

分 类 号：R692[医药卫生—泌尿科学] R683[医药卫生—外科学]