FRAX 骨折风险预测工具在新疆地区人群的临床研究

摘要

目的：评估FRAX骨折风险预测工具在新疆地区人群的适用性研究，并且探讨有、无股骨颈骨密度（ BMD）及不同民族对FRAX预测结果的影响。方法选取2012年7月-2013年6月期间在我院就诊的骨质疏松性骨折患者103例（汉族63例，维吾尔族40例）进行回顾性分析。收集所有入选患者FRAX预测工具中所包含的各危险因素资料，将包括股骨颈BMD等数值输入FRAX工具，计算10年内主要部位（包括髋部、脊柱、肱骨及腕部）及髋部骨折的概率进行分析，并且对不同民族及有、无股骨颈BMD情况下FRAX预测值进行比较。结果103例骨质疏松性骨折患者，未使用BMD未来10年主要部位骨折概率0.9％～14％，髋部骨折概率0％～5.2％；使用BMD未来10年主要部位骨折概率1.2％～26％，髋部骨折概率0％～17％，使用BMD计算的骨折概率与未使用BMD计算的骨折概率之间无统计学意义（ P＞0.05）。不同民族，汉族未来10年主要骨折部位概率1％～26％，髋部骨折概率0％～17％；维吾尔族未来10年主要骨折部位概率0.9％～7％，髋部骨折概率0％～3.4％，汉族与维吾尔族主要部位骨折及髋部骨折概率之间比较有明显差异（P＜0.01）。结论 FRAX可用于新疆地区人群的骨折风险预测，无BMD情况下的FRAX预测结果同样可靠，维吾尔族人群使用FRAX骨折风险预测的精确性可能低于汉族人群。%Objective To evaluate the applicability of fracture risk prediction tool FRAX in the population in Xinjiang, and to investigate the effect of FRAX on fracture prediction with or without the availability of bone mineral density ( BMD) of the femoral neck in different nationalities.Methods A total of 103 patients (63 were Han and 40 were Uygur) with osteoporotic fractures, who were treated in our hospital from July 2012 to June 2013, were selected.The clinical data of all the patients were retrospectively analyzed.All the risk factors contained in FRAX prediction tool were collected.The data including BMD of the femoral neck were input into the FRAX prediction tool.Then, the fracture probability of main parts ( the hip, the spine, the humerus, and the wrist) and the hip in the next 10 years was calculated.With the consideration of different nationalities and with or without BMD of the femoral neck, the FRAX results were compared.Results In all 103 patients with osteoporotic fractures, without BMD in the tool, the fracture probability of main parts and the hip in the next 10 years was 0.9%-14%and 0%-5.2%, respectively.When with BMD in the tool, the fracture probability of main parts and the hip in the next 10 years was 1.2%-26% and 0%-17%, respectively.And no significant difference of the fracture probability was observed with or without BMD ( P>0.05 ) .Considering different nationalities, with the Han nationality in the tool, the fracture probability of main parts and the hip in the next 10 years was 1%-26%and 0%-17%, respectively.As for Uighur, the probability was 0.9%-7%and 0%-3.4%, respectively.And the difference of the fracture probability of main parts and the hip between Han and Uygur was significant (P<0.01).Conclusion FRAX fracture risk prediction tool can be used in the population in Xinjiang.Without BMD, the FRAX predicted results are also reliable.The accuracy of FRAX fracture risk prediction in Uighur population may be lower than that in Han population.