摘要
目的通过对社区中老年人群骨质疏松性骨折风险的评估,提出针对性的社区干预策略。方法随机抽取上海市欧阳社区2 992例中老年人进行体质指数(BMI)测量和超声骨密度检查,并应用WHO推荐的骨折风险预测工具(FRAX)对未来10年主要骨质疏松性骨折(MO)和髋部骨折(HF)发生概率进行评估分析。结果 45～59岁、60～79岁和≥80岁组发生MO概率≥20%的检出率间差异无统计学意义(χ2总=3.634,P>0.05);其HF概率≥3%的检出率随年龄增高呈现上升趋势,≥80岁组高于60～79岁组,且60～79岁组高于45～59岁组,差异均有统计学意义(χ260～79-≥80=31.683,χ245～59-60～79=25.339,P<0.05)。女性发生MO概率≥20%的检出率与男性比较〔6/2 228(0.27%)和0〕,差异无统计学意义(χ2=2.062,P>0.05);女性发生HF概率≥3%的检出率与男性比较〔112/2 228(5.03%)和5/764(0.65%)〕,差异有统计学意义(χ2=28.947,P<0.05)。不同体质量组发生MO概率≥20%的检出率间差异无统计学意义(χ2总=3.571,P>0.05);其发生HF概率≥3%的检出率间差异有统计学意义(χ2总=49.579,P<0.05)。3组不同骨量的中老年人发生MO概率≥20%的检出率间差异无统计学意义(χ2总=2.949,P>0.05);其发生HF概率≥3%的检出率间差异有统计学意义(χ2总=73.580,χ2骨量正常-骨量减少=19.231,χ2骨量正常-骨质疏松=77.746,χ2骨量减少-骨质疏松=18.861,P<0.05)。结论以年龄、性别、BMI、骨量为基础,结合FRAX和超声骨密度测量的综合性评估方法在骨质疏松性骨折风险评估方面更具有客观性和实用性,对于社区开展骨质疏松分层干预具有指导意义。
Objective To carry out risk assessment of osteoporotic fractures among the elderly in community. Meth- ods Totally 2 992 elderly subjects were randomly enrolled from Ouyang Community in Shanghai. Their body mass index （BMI） and ultrasound bone density were measured, and the probabilities of major osteoporotic fracture （MO） and hip fracture （HF） in the next 10 years were assessed by fracture risk prediction tools FRAX recommended by WHO. Results The probability of MO greater than or equal to 20% showed no significant difference among three age groups （45 to 59 years, 60 to 79 years, and grea- ter than or equal to 80 years） （ X2total = 3. 634, P 〉 0.05 ）. The probability of HF greater than or equal to 3 % showed a monotonic upward trend with aging, greater than or equal to 80 years higher than 60 to 79 years, and 60 to 79 years higher than 45 to 59 years, showing a significant difference（ X60-79≥802 = 31. 683, X452 -59-60-79 = 25. 339, P 〈 0. 05 ）. The probability of MO greater than or equal to 20% was higher in elderly women than in elderly man [6/2228 （0. 27% ） and 0], but showing no significant difference （ X2 = 2. 062, P 〉 0.05 ）. The probability of HF greater than or equal to 3% was higher in elderly women than in eld- erly man [ 112/2228 （ 5.03% ） vs 5/764 （ 0. 65% ） ], showing significant in difference （ X2 = 28. 947, P 〈 0.05 ）. The probability of MO greater than or equal to 20% showed no significant difference among different BMI groups （X2totla = 3. 571, P 〉 0.05 ） , although the probability of HF greater than or equal to 3% in low BMI group was significantly than other groups （X2total = 49. 579, P 〈 0. 05）. The probability of MO greater than or equal to 20% showed no significant difference among three groups with different BMI （ X2total = 2. 949, P 〉 0. 05 ） , whereas significant difference was detected in terms of the probability of HF grea ter than or equal to 3% （X2total 73.580, x^2 normal bone mass index-low BMI=19.231,x2 NORMAL bmi-csteoporosis=77.746,x＆2low BMI-osteoporosis= 18. 861, P 〈 0. 05）. Conclusion Community -based comprehensive risk assessment is objective and feasible for evaluating the osteoporotic fractures among the elderly.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第26期2990-2992,共3页
Chinese General Practice
基金
上海市虹口区2011年度社区基本公共卫生项目
关键词
骨质疏松
社区
骨折
中年人
老年人
风险评估
Osteoporosis
Community
Fracture
Middle aged
Aged
Risk assessment
