骨质疏松性骨折患者出院后抗骨质疏松治疗率及其影响因素调查  

Investigation of anti-osteoporosis treatment rate and its affecting factors in patients after osteoporotic fracture

作　　者：白梦薇 刘婉琪 刘雨则 杨雨濛 卜石[2] BAI Mengwei;LIU Wanqi;LIU Yuze;YANG Yumeng;BU Shi(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Endocrinology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院内分泌科,北京100029

出　　处：《中国骨质疏松杂志》2025年第4期512-517,共6页Chinese Journal of Osteoporosis

基　　金：国家重点研发计划项目子课题(2018YFC2002303);中央高水平医院临床科研业务费资助(2022-NHLHCRF-LX-02-0108)。

摘　　要：目的调查因骨质疏松性骨折于三甲医院骨科住院的患者在出院后的抗骨质疏松治疗率及其影响因素。方法纳入自2019年1月1日至2021年12月31日因骨质疏松性骨折住院的病例。查阅病历,收集患者住院信息,以电话随访形式调查患者出院后接受抗骨质疏松治疗情况,通过患者本人对研究者自行设计的8个简单问题的回答了解患者对骨质疏松症的认知水平。结果共得到符合入排标准的病例443例,年龄(76.0±10.6)岁,其中女性占70.0%,入院时骨折部位髋部占60.9%,椎体占35.4%。198例参与电话随访,电话随访距患者出院时间平均为(22.5±12.9)个月。其中出院后应用钙剂的比例为40.9%,补充维生素D>400 IU/d者占8.1%。应用活性维生素D治疗者占13.1%。应用过双膦酸盐、地舒单抗、特立帕肽和抗骨质疏松中成药治疗者分别占4.5%、2.0%、0%和5.6%。接受过X线双能骨密度(DXA)检查者占23.7%。Logistic二元回归分析显示患者对骨质疏松症认知评分与其是否规律应用钙剂呈显著正相关(OR=1.195,95%CI:1.023~1.394,P=0.024),独立于患者的年龄、性别、骨折部位及卡森伴随疾病指数。结论骨质疏松性骨折患者在出院后钙剂和维生素D补充的比例极低,抗骨质疏松药物(包括抗骨吸收药物或促骨形成药物)应用严重不足。提高患者对骨质疏松症的认知是改善抗骨质疏松治疗率的重要策略之一。Objective To explore treatment rate of osteoporosis and its affecting factors in patients after osteoporotic fracture.Methods Patients admitted for an osteoporotic fracture between Jan 1,2019 to Dec 31,2021 were recruited in the study.Medical records were searched from Hospital Information System.Then telephone visits were conducted about their medication related to osteoporosis.A questionnaire including 8 simple questions designed by researchers was also applied to each patient to evaluate his knowledge about osteoporosis.Results A total of 443 patients were included in this study(age 76.0±10.6 years,female 70.0%)with 60.9%hip fracture and 35.4%vertebral fracture.198 patients responded to the telephone visit.The average interval between the telephone follow-up and their discharge were 22.5±12.9 months.Among them,40.9%received calcium supplements and only 8.1%accepted vitamin D over 400iu per day.Patients received vitamin D analogue,bisphosphate,denosumab or teriparatide were 13.1%,4.5%,2%and 0%,respectively.There were 5.6%patients taking traditional Chinese anti-osteoporosis medicine.Only 23.7%patients had at least once bone density test.If calcium supplementation was used as an indicator of patients’acceptance of anti-osteoporotic treatment,multivariate logistic regression analysis suggested that knowledge about osteoporosis was the only variable that significantly correlated to calcium supplementation(OR=1.195,95%CI:1.023-1.394,P=0.024)independent of age,sex,site of fracture and Charlson comorbidity index.Conclusion The proportion of patients received calcium and vitamin D supplement after osteoporotic fracture was extremely low after they discharged from hospital.The application of anti-osteoporotic drugs,including anti-bone resorption or anabolic agents,was seriously insufficient.Health education to improve patients’awareness of osteoporosis may be an important strategy to improve the current low anti-osteoporosis treatment rate.

关 键 词：骨质疏松症 骨质疏松性骨折 再发骨折 治疗率 

分 类 号：R589.5[医药卫生—内分泌] R683[医药卫生—内科学]