应用FRAX工具评估骨折风险的回顾性研究

Retrospective study of fracture risk assessment with FRAX tool

目的 通过对国内已发表使用FRAX工具进行骨折风险评估的相关文献进行分析评价,寻找更适合国人的FRAX评估骨折风险的国内阈值。方法 检索2021年4月以前的中国知网与万方数据库,主题词为“FRAX”,检索筛选出有具体FRAX计算结果 、样本量≥30例和以国人为研究对象的文献,由2名评价者单独进行资料提取,做出文献质量评价后,摘录文中相关数据,采用SPSS 17.0软件进行统计分析。结果 共检索到216篇相关文献,其中19篇文献符合标准,包括20508例次数据,其中男性11632例,女性8876例。将男女的结果 分开统计计算,使用FRAX工具评估10年全身多部位骨折发生概率(PMOF),其中女性为(4.01±1.57)%,男性为(2.94±1.91)%,使用FRAX工具评估10年内髋部骨折风险概率(PHF),其中女性为(1.25±0.68)%,男性为(1.09±0.75)%,男女在10年内PMOF及PHF的差异均具有统计学意义(P<0.05)。结论 国内FRAX工具估算10年PMOF和PHF与国外指南存在差异,PMOF推荐男性参考3%、女性参考4%;PHF推荐男性参考1%,女性参考1.25%。

Objective To find a more suitable threshold of fracture risk assessment using in China by analyzing and evaluating the published literature on fracture risk assessment with FRAX tool.Methods Literature with specific FRAX calculation result,sample size≥30,and Chinese as research subjects were retrieved from CNKI and Wanfang databases before April 2021 with the keyword FRAX.Two evaluators independently extracted the data,evaluated the literature quality,and extracted the relevant data.SPSS17.0 software was used for statistical analysis.Results A total of 216 related articles were retrieved.Among those,19 articles met the criteria,including 20508 cases,with 11632 male cases and 8876 female cases.The 10-year risk of multisite fracture(PMOF)was assessed using FRAX tool.The incidence was 4.01%±1.57%in women and 2.94%±1.91%in men,respectively.The 10-year risk of hip fracture(PHF)was 1.25%±0.68%in women and 1.09%±0.75%in men using the FRAX tool.There were statistically significant differences in PMOF and PHF between males and females in 10 years(P<0.05).Conclusion The 10-year PMOF and PHF estimated by FRAX are different from foreign guidelines.It is recommended that PMOF is 3%in men and 4%in women,and PHF is 1%in men and 1.25%in women.