FRAX联合DXA对骨质疏松症患者骨折的预测效果研究

Effect of Fracture Risk Assessment Tool combined with dual-energy X-ray absorptiometry in predicting fractures in patients with osteoporosis

摘要:

目的：探究FRAX联合DXA对骨质疏松症患者骨折的预测效果。方法：回顾性分析2016年1月至2019年1月我院收治的3 000例骨质疏松患者的临床资料，每位患者均行FRAX评估和DXA检查。分析不同性别患者FRAX评估骨折风险情况，记录L2-4前后位和侧位各年龄段骨密度（bone mineral density，BMD）测定结果、L2-4前后位和侧位各年龄段骨折检出率和不同部位骨折结果。结果：男女髋部骨折风险经FRAX评估差异均无统计学意义（P＞0.05），任意部位骨折风险女性患者均高于男性（P＜0.01）。3 000例患者前后位BMD测定结果中，529例T值＞-1.0 s，-1.0 s≥T值＞-2.0 s者1 426例，-2.0 s≥T值＞-2.5 s者572例，455例T值≤-2.5 s。3 000例患者侧位BMD测定结果中，424例T值＞-1.0 s，-1.0 s≥T值＞-2.0 s者717例，-2.0 s≥T值＞-2.5 s者808例，1 181例T值≤-2.5 s。L2-4前后位的骨折检出率分别为34.80％（T值≤-2.0 s）和15.60％（T值≤-2.5 s），侧位的骨折检出率分别为57.60％（T值≤-2.0 s）和39.37％（T值≤-2.5 s）。3 000例患者中，348例脊柱骨折，622例髋部骨折，1 154例腕部骨折，876例股骨颈骨折，不同部位骨折患者的前后位T值和侧位T值情况比较无统计学差异（P＞0.05）。结论：FRAX对骨质疏松症患者的骨折评估效果较佳，女性患者的评估效果优于男性患者。DXA对骨质疏松症患者具有较佳的预测效果，T值≤-2.0 s可作为预测骨折的标准值。

Abstract:

Objective：To investigate the effect of Fracture Risk Assessment Tool（FRAX） combined with dual-energy X-ray absorp－tiometry（DXA） in predicting fractures in patients with osteoporosis. Methods：A retrospective analysis was performed for the clinical data of 3 000 patients with osteoporosis who were admitted to our hospital from January 2016 to January 2019，and all patients under－went FRAX assessment and DXA examination. The risk of fractures determined by FRAX was compared between male and female patients. Bone mineral density（BMD） in the anterior，posterior，and lateral positions of L2-4，detection rate of fractures in the anterior，posterior，and lateral positions of L2-4，and outcomes of fractures at different sites were recorded for patients in different ages. Results：There was no significant difference in the risk of hip fracture determined by FRAX between male and female patients（P>0.05），and female patients had higher risk of fractures at each site than male patients（P<0.01）. Among the 3 000 patients with an－terior and posterior BMD measurements，529 patients had a T value of >-1.0 s，1 426 patients had a T value of ≤-1.0 s and >-2.0 s，572 patients had a T value of ≤-2.0 s and >-2.5 s，and 455 patients had a T value of ≤-2.5 s. Among the 3 000 pa－tients with lateral BMD measurements，424 patients had a T value of >-1.0 s，717 patients had a T value of ≤-1.0 s and >-2.0 s，808 patients had a T value of ≤-2.0 s and >-2.5 s，and 1 181 patients had a T value of ≤-2.5 s. The detection rates of fractures at the anterior and posterior positions of L2-4 were 34.80%（T value≤-2.0 s） and 15.60%（T value≤-2.5 s），respectively，and the detection rates of fractures at the lateral position were 57.60%（T value ≤-2.0 s） and 39.37%（T value≤-2.5 s），respectively. Of all 3 000 patients，348 had spinal fractures，622 had hip fractures，1 154 had wrist fractures，and 876 had femoral neck fractures，and there were no significant differences in the T val－ues of the anterior/posterior and lateral positions between the patients with fractures at different sites（P>0.05）. Conclusion：FRAX has a good effect in evaluating fractures in patients with osteoporosis，with a better effect in female patients than in male pa－tients. DXA has a good predictive effect in patients with osteoporosis，and a T value of ≤-2.0 s can be used as a standard value for the prediction of fracture.