摘要
目的比较TVF模型与FRAX模型对骨折风险分层的预测效能。方法采用单中心前瞻性真实世界研究,纳入2022年4~6月南方医院骨质疏松门诊患者91例(最终73例完成1年随访),收集基线数据后通过FRAX分低危(53例)/高危(38例)两组,TVF分低(9例)、中(39例)、高危(25例)3组,每3个月随访实际骨折发生情况。结果两组模型中,最低骨密度T值、骨折史在风险分层间均存在显著差异(P<0.05),FRAX组年龄差异显著。FRAX高危组EQ-5D-5L生活质量评分中活动能力、日常活动及总分显著更低。实际骨折发生率:FRAX高危组22.6%(7/31)vs低危组0%(0/42);TVF高危组24%(6/25)vs中危组2.5%(1/39)vs低危组0%(0/9)。结论TVF和FRAX均具有对骨折风险分层的效能,FRAX在某种程度上可区分患者的生活质量,但也存在低估骨折风险的可能性。TVF作为一种着重研究骨质疏松椎体骨折风险的模型,其有效性和简便适用性为未来的研究奠定了基础。
Objective To compare the predictive efficacy of the vertebral fracture risk model(TVF)and fracture risk assessment tool(FRAX)in stratifying fracture risk among osteoporotic patients.Methods A single-center prospective real-world study included 91 patients from the Osteoporosis Clinic of Nanfang Hospital(April-June 2022),with 73 cases of completing 1-year follow-up.After collecting the baseline data,the patients were classified into two groups based on the FRAX model:low-risk group(53 cases)and highrisk group(38 cases),classified into three groups based on TVF model:low-(n=9),medium-(n=39),and highrisk(n=25)groups.Fracture incidence was followed-up every 3 months.Results Among the two groups of models,there were significant differences in bone mineral density T-scores and fracture history between the risk stratification groups(P<0.05),and the age difference was significant in the FRAX group.The FRAX highrisk group showed lower EQ-5D-5L scores in mobility(2.1±0.8 vs 1.3±0.6),daily activities(2.4±0.7 vs 1.5±0.5),and total scores(8.2±1.9 vs 6.1±1.5,P<0.05).Actual fracture incidence:22.6%in FRAX high-risk group(7/31)vs 0%in low-risk group(0/42);24%in TVF high-risk group(6/25)vs 2.5%in medium-risk group(1/39)vs 0%in low-risk group(0/9).Conclusions Both TVF and FRAX have the efficacy of stratifying fracture risk,to some extent,FRAX can distinguish the quality of life of patients,but there is also the possibility of underestimating the fracture risk.As a model that focuses on studying the risk of osteoporotic vertebral fractures,TVF's effectiveness and ease of application lay the foundation for future research.
作者
朱永健
林省梁
杨德鸿
冯岚
Zhu Yongjian;Lin Shengliang;Yang Dehong;Feng Lan(Division of spine Surgery,Department of Orthopaedics,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China)
出处
《中国临床解剖学杂志》
北大核心
2025年第5期578-583,共6页
Chinese Journal of Clinical Anatomy
基金
国家自然科学基金(82271616)
广州市科技计划项目(202103000052)。
关键词
椎体即刻骨折
骨质疏松症
绝经后妇女
Immediate vertebral fracture
Osteoporosis
Postmenopausal women
