FRAX工具对类风湿关节炎患者骨折风险评估的初步研究

摘要

Objective To study the prediction value of osteoporotic fractures in patients of rheumatoid arthritis (RA) with fracture risk assessment tool (FRAXTM). Methods The relative clinical indicators including age, weight, BMI,history of previous fracture,and bone mineral density(BMD)values of 68 patients with rheumatoid arthritis(RA group),who admitted and confirmed at Department of Nuclear Medicine of Taihe Hospital of Hubei University of Medi-cine from March 2016 to February 2017, were retrospectively analyzed.The related clinical data were compared with those of 72 normal cases at same period(the control group).The corresponding fracture risk was calculated by FRAXTM software and analyzed statistically. Results The BMI and past fracture history were respectively (23.26±2.17) kg/m2 and (7.45±0.12)% in the RA group versus (27.45±4.30) kg/m2and (4.56±0.26)% in the control group (P<0.05).The BMD value of femoral neck and lumbar spine in the RA group were(0.55±0.13)g/cm2and(0.52±0.18)g/cm2,which were significantly lower than(0.85±0.36)g/cm2and(0.68±0.23)g/cm2in the control group(P<0.05).The 10-year pri-mary osteoporosis fracture probability and hip fracture probability were(3.46±0.32)% and(6.25±1.12)%,which were significantly higher than(1.32±0.29)% and(1.01±0.78)% in the control group(P<0.05).Conclusion FRAXTMtools are useful in the evaluation of the risk and prognosis of osteoporotic fractures in RA patients,and can provide a basis for clinical treatment.%目的 应用骨折风险评估工具(FRAX)评估类风湿关节炎(RA)患者骨质疏松性骨折风险,探讨其临床应用价值.方法 回顾性分析2016年3月至2017年2月期间经十堰市太和医院核医学科确诊的68例类风湿关节炎患者(RA组)的相关临床指标(年龄、体质量、BMI、既往骨折史等)和骨密度值,并与同期随机纳入的72例健康中老年人(对照组)进行比较,通过FRAX软件计算相应骨折风险并进行统计学分析.结果 RA组患者的BMI和既往骨折史分别为(23.26±2.17)kg/m2、(7.45±0.12)%;对照组分别为(27.45±4.30)kg/m2、(4.56±0.26)%,两组比较差异均有统计学意义(P<0.05);RA组患者的股骨颈、腰椎的骨密度值分别为(0.55±0.13)g/cm2、(0.52±0.18)g/cm2,均低于对照组的(0.85±0.36)g/cm2、(0.68±0.23)g/cm2,差异有统计学意义(P<0.05);RA组的10年主要骨质疏松性骨折发生概率和10年髋部骨折发生概率分别为(3.46±0.32)%和(6.25±1.12)%,均高于对照组的(1.32±0.29)%和(1.01±0.78)%,差异均有统计学意义(P<0.05).结论 FRAX工具在评估RA患者骨质疏松性骨折风险、随访等方面具有很强的实用性,为临床治疗提供决策依据.