中国全科医学2016，Vol.19Issue(14)：1620-1624,5.DOI:10.3969/j.issn.1007-9572.2016.14.003
骨质疏松性骨折风险预测简易工具筛查社区绝经后妇女骨量异常的效果评价
Effectiveness of FRAX for Osteopenia in the Screening of Abnormal Bone Mass Among Community Postmenopausal Women
摘要
Abstract
Objective To observe the effectiveness of fracture risk assessment tool( FRAX)for osteopenia in the screening of abnormal bone mass among community postmenopausal women. Methods From August 2011 to July 2012,we enrolled postmenopausal women from Yuetan Community Health Service Center of Fuxing Hospital Affiliated to Capital Medical University,Guangnei Community Health Service Center,Tiantan Community Health Service Center and Shuangyushu Community Health Service Center by volunteer recruitment and using purposive sampling method. Using cross _ sectional research method, 10 _ year probability of hip fracture and 10 _ year probability of a major osteoporotic fracture were calculated using FRAX,and at the same time,bone mineral density was measured using dual _ energy X _ ray absorptiometry( DXA),divided into normal bone mass,low bone mass and osteoporosis according to bone mineral density T value. To observe the value of FRAX positive (the 10 _ year probability of hip fracture was 3. 0% or higher and the 10 _ year probability of a major osteoporotic fracture was 20. 0% or higher)predict abnormal bone mass( low bone mass and osteoporosis). Results A total of 759 postmenopausal women were enrolled,including 308 women aged < 60,251 women aged 60 _ 69 and 200 women aged ≥70 and including 253 (33. 3% )women with normal bone mass,368 ( 48. 5% ) women with low bone mass and 138 ( 18. 2% ) women with osteoporosis. Women of different age groups were significantly different in bone mass(χ2 = 120. 591,P < 0. 001). Women of different age groups were significantly different in the 10 _ year probability of hip fracture and the 10 _ year probability of a major osteoporotic fracture(F = 110. 155,P < 0. 001;F = 13. 501,P < 0. 001). Normal bone mass group,low bone mass group and osteoporosis group were significantly in 10 _ year probability of hip fracture(F = 25. 259,P < 0. 001),but no significantly in 10 _ year probability of a major osteoporotic fracture(F = 1. 389,P = 0. 250). There were 27(3. 6% )subjects with FRAX positive and 732(96. 4% )subjects with FRAX negative. The sensitivity,specificity,Youden' s index,positive predictive value and negative predictive value of FRAX in the positive screening of abnormal bone mass were 4. 3% ,98. 0% ,2. 3% , 81. 5% and 33. 9% ,Kappa = 0. 016(P = 0. 096). The Youden's index of 10 _ year probability of hip fracture in the screening of abnormal bone mass reached the highest 38. 6% at a critical value of 0. 6% with sensitivity of 69. 4% and specificity of 69. 2% . The Youden's index of 10 _ year probability of a major osteoporotic fracture in the screening of abnormal bone mass reached the highest 12. 8% at a critical value of 2. 8% with sensitivity of 50. 0% and specificity of 62. 8% . Conclusion The screening of abnormal bone mass by FRAX has poor accuracy,so FRAX is not suitable for community screening.关键词
骨质疏松性骨折/骨质疏松,绝经后/多相筛查Key words
Osteoporotic fractures/Osteoporosis,postmenopausal/Multiphasic screening分类
医药卫生引用本文复制引用
孙艳格,阮祥燕,杜雪平,黄凯,于溯..骨质疏松性骨折风险预测简易工具筛查社区绝经后妇女骨量异常的效果评价[J].中国全科医学,2016,19(14):1620-1624,5.基金项目
北京市西城区2013年优秀人才培养资助项目（20130046）；北京市卫生系统高层次卫生技术人才培养计划 （）
