| 赵建辉,王梦云,徐晓榕,石媛,潘丽青.FRAX计算与不计算骨密度评估慢性肾脏病非透析患者骨质疏松性骨折风险的对比研究[J].浙江中西医结合杂志,2017,27(4): |
| FRAX计算与不计算骨密度评估慢性肾脏病非透析患者骨质疏松性骨折风险的对比研究 |
| Contrastive study on assessment of osteoporotic fracture risk by FRAX withSand without bone mineral density in non-dialysis patients with chronic kidney disease ZHAO Jian-hui,WANG Meng-yun,XU Xiao-rong,SHI Yuan,PAN Li-qing.Department of Nephrology, Xin-chang People"s Hospital of Zhejiang Province, Xinchang 312500, China. |
| 投稿时间：2016-09-19 修订日期：2016-11-03 |
| DOI： |
| 中文关键词: 骨折风险评估工具 骨质疏松性骨折 慢性肾脏病 非透析患者 |
| 英文关键词:Fracture risk assessment tool Osteoporotic fracture Chronic kidney disease non-dialysis patients |
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| 中文摘要: |
| 【摘要】 目的 对比分析骨折风险评估工具(FRAX)计算与不计算骨密度评估慢性肾脏病3~5期非透析患者骨质疏松性骨折风险的差异。 方法 90例慢性肾脏病患者依据估计的肾小球滤过率(eGFR)分为3组：CKD3期组(eGFR为30～60ml/min/1.73m2)、CKD4期组(eGFR为15～30ml/min/1.73m2)、CKD5期组(eGFR<15ml/min/1.73m2)。应用双能X射线吸收法(DEXA)测量股骨颈骨密度(BMD)并进行骨折风险因素问卷调查,记录患者的临床及生化指标,FRAX计算患者的骨质疏松性骨折概率进行骨折风险评估。 结果 1)CKD3~5期各期患者的骨密度无统计学差异(P>0.05)。2) FRAX计算与不计算骨密度评估患者骨折风险等级的结果是一致的,但亚组分析的结果不同。如果计算骨密度,3组间骨折风险有统计学差异(P<0.05),与CKD3期、CKD4期比较,CKD5期的骨折风险明显增加(均P<0.05),而不计算骨密度,3组骨折风险无统计学差异(P>0.05)。3)计算BMD评估骨折风险,ROC曲线下面积为0.921,而不计算BMD评估骨折风险,ROC曲线下面积为0.944,P值均>0.05。结论 FRAX计算与不计算骨密度评估患者骨折风险等级的结果一致,但亚组分析的结果不同,两种方法均不能识别CKD非透析患者的骨折状态。 |
| 英文摘要: |
| 【Abstract】 Objective TO comparative analysis the differences of osteoporotic fracture risk in non-dialysis patients with chronic kidney disease (CKD) 3~5 stages by fracture risk assessment tool (FRAX) with and without bone mineral density. Methods 90 patients with chronic kidney disease were divided into 3 groups according to the estimated glomerular filtration rate (eGFR): CKD3stage group (eGFR, 30 to 60ml/min/1.73m2), CKD4stage group (eGFR, 15 to 30ml/min/1.73m2) and CKD5stage group (eGFR<15ml/min/1.73m2). To measure femoral neck bone mineral density(BMD)with dual energy X-ray absorptiometry (DEXA)and make a fracture risk factors questionnaire in patients, clinical and biochemical indicators were recorded. The risk of osteoporotic fractures in patients was assessed with FRAX. Results 1) There was no statistical difference in bone mineral density (P>0.05) in patients with CKD3~5 phase. 2) Assessment of fracture risk in patients by FRAX with and without bone density was consistent, whereas subgroup analysis results were different. If bone mineral density (BMD) was calculated, fracture risk of three groups was statistically significant difference (P < 0.05), and compared to CKD stage3 and stage4, fracture risk in patients with CKD stage5 was increased significantly (P < 0.05), instead of calculating bone density, fracture risk of three groups was no statistical difference (P > 0.05). 3) assessment of fracture risk with BMD, the area under the ROC curve was 0.921, assessment of fracture risk without BMD, the area under the ROC curve was 0.944, P >0.05. Conclusion The assessment of fracture risk in patients by FRAX with and without bone density was consistent, but the results of subgroup analyses were different, and both of the two methods could not identify the fracture status of CKD patients with non-dialysis. |
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