老年人原发性骨质疏松症简易筛检表

Simple screening table for primary osteoporosis in senior people

目的:建立男女通用的老年人原发性骨质疏松症(primary osteoporosis,POP)简易筛检表。方法:对146名≥60岁的社区居民进行骨质疏松症危险因素调查及骨密度检测,以多元逐步回归筛选危险因素,进而建立筛检指数,并求得最适宜灵敏度、特异度时的临界值,据此制定老年人原发性骨质疏松症简易筛检表,以61名门诊骨密度检测者回代验证其筛检原发性骨质疏松症效度和信度。结果:多元逐步回归共筛选出身高缩短百分比、体质量、年龄、性别4个因素,最终以身高缩短百分比和体质量构建老年人POP简易筛检表,其最佳临界值为270,灵敏度为88.9%,特异度为75.7%。回代验证其符合率为75.4%,Kappa值为0.489。结论:以身高缩短百分比和体质量建立的老年人POP简易筛检表简单经济,可男女通用,具有较好的基层卫生服务价值。

Objective To develop a simple screening table for primary osteoporosis （POP） in senior men and women. Methods Questionnaires were designed to obtain the risk factors associated with osteoporosis and bone mineral density （BMD） , which were measured in 146 community residents over 60. The multiple stepwise regression was used to find out the risk factors and establish the screening index. Then the cut-off point of sensitivity and specificity were obtained. Simple screening table for POP in senior people was established according to the screening index and the cut-off point. Validity and reliability of the simple screening table for POP in senior people were testified by 61 outpatients whose BMD was measured with dual energy X-ray （ DEXA ）. Results Percentage of the height loss, body weight, age, and gender were selected with multiple stepwise regression. Percentage of height loss and body weight were selected to develop the simple screening table for POP in senior people. The cut-off point was 270, sensitivity was 88.9 % , specificity was 75.7 % , the agreement rate was 75.4 % , and the Kappa value was 0. 489. Conclusion The simple screening table for POP in senior people based on the percentage of height loss and body weight is simple, economic, suitable for both men and women, and is useful in basic public health.