骨质疏松症高骨折风险患者的识别与防治策略

Identification and management strategies for osteoporosis patients with high fracture risk

我国骨质疏松症患病率伴随人口老龄化及生活方式的变化已经明显增加,未来将有更庞大的骨质疏松症人群。骨质疏松性骨折(或称脆性骨折)指受到轻微创伤或日常活动中即发生的骨折,是骨质疏松症的严重后果,疾病负担沉重。防治骨质疏松症的根本目的是减少骨折。建立骨折风险预测模型,用于人群筛查,锚定骨折高危人群,精准有效防治。中国骨质疏松性骨折风险评估可在我国现有指南推荐的基础上,引入极高风险分层,强调脆性骨折史,尤其近2年内骨折史对未来骨折风险的预测价值。针对不同风险给予不同的干预,并做好综合管理。

With the aging of population and the change of lifestyle,the prevalence of osteoporosis in China has increased.There will be a larger population of osteoporosis in the future.Fragility fractures are a major cause of morbidity in the population.The high societal and personal costs of fragility fractures pose challenges to public health particularly since most patients with osteoporosis remain untreated.Primary purpose of osteoporosis management is to reduce the fracture incidence.By establishing a strategy of fracture risk assessment,“high risk”population can be identified and treated precisely.Addition to the current Chinese guideline,data suggest that a recent fracture(within the past 2 years)is a better predictor of imminent fracture risk.According to fracture risk stratification,different comprehensive management strategies are provided.