骨质疏松性骨折与再骨折风险评估的研究进展

Risk assessments for osteoporotic fracture and refracture

骨质疏松是一种以骨量减少、骨组织显微结构退行性改变为特征,可导致骨脆性增加和骨折风险升高的代谢性骨病。骨质疏松后骨折是骨质疏松最常见、最严重的并发症,常因为预防不足、诊断不及时而带来严重后果。因此,骨质疏松的预防和骨质疏松后骨折与再骨折的风险评估的重要性逐年增加。本综述从影像学特征、临床表现及实验室检查指标3个方面回顾近年来骨质疏松后骨折与再骨折风险评估的研究进展。近年来,影像学水平从双能X线吸收法、骨小梁评分、CT到高分辨率周边定量CT;临床表现上从独立危险因素到骨折风险评估工具;实验室检查从骨转换标志物、5-羟色胺到微小RNA,不断提高了骨质疏松后骨折和再骨折的风险评估的敏感性,但也存在相应问题还需要不断探究和完善。

Osteoporosis is a metabolic bone disease characterized by decreased bone mass and degenerative changes in the microstructure of bone tissue,leading to increased bone brittleness and fracture risk.Bone fracture after osteoporosis is the most common and serious complication,which often leads to serious consequences in cases of inadequate prevention and late diagnosis.Therefore,more attention should be paid to prevention of osteoporosis and risk assessment of fracture and refracture after osteoporosis.This paper reviews the research progress in risk assessment of fracture and refracture after osteoporosis from the aspects of imaging,clinical manifestations and laboratory examination indexes.In recent years,the imaging methods have developed from dual-energy X-ray absorption,trabecular bone scoring and CT to high resolution peripheral quantitative CT;concern for their clinical manifestations has developed from independent risk factors to fracture risk assessment tools;the laboratory tests have developed from bone turnover markers and serotonin to microRNA.Although these developments have consistently increased the sensitivity of risk assessment for fracture and refracture after osteoporosis,problems still exist and need to be resolved.