FRAX在女性骨质疏松症诊疗中的应用研究

Research progress of FRAX in the diagnosis and treatment of female osteoporosis

骨质疏松症是常见的骨骼疾病,绝经后女性为骨质疏松症的高危人群。骨折风险评价工具(fracture risk assessment tool,FRAX)是一款研究、应用广泛的骨折风险评估工具。近年来研究表明,虽然FRAX尚不完美,但对女性人群的骨折具有合理的预测能力,结合其他骨折危险因素对该工具进行调整、改进的研究也多见报道。设立符合本国国情的FRAX阈值有助于医生更好地使用该工具和进行临床决策。美国设立了固定的FRAX阈值,英国则是按年龄分层的阈值。国内对FRAX的研究尚处于初级阶段,暂无特异的干预阈值,这在一定程度上阻碍了该工具在我国的推广使用。笔者回顾了国内外FRAX对女性骨质疏松性骨折的预测能力、骨量异常的诊断能力、在合并其他疾病的女性人群中的应用和干预阈值的研究等最新成果,为临床医生了解FRAX的研究进展、探索针对我国人群干预阈值奠定基础。

Osteoporosis is a kind of common bone disease,and postmenopausal women are at high risk of osteoporosis.FRAX(fracture risk assessment tool)is a fracture risk assessment tool that has been widely studied and used.Recent studies have shown that although FRAX is not perfect,the performance of FRAX in predicting fractures in women is reasonable.And there are many reports on the adjustment and improvement of FRAX in combination with other fracture risk factors.Setting a FRAX threshold in line with national conditions will help doctors to make better use of FRAX as well as to make decisions in clinical practice.A fixed FRAX intervention threshold is recommended in the USA.In the UK,there is an age-dependent threshold using FRAX.In China,however,the research on FRAX is still at the early stagy.There is no specific intervention threshold,which to a certain extent hinders the promotion and use of FRAX.This paper reviews the latest research progress of FRAX at home and abroad in the following respects:the prediction ability of female osteoporotic fractures,the diagnosis ability of abnormal bone mass,the application in women with other diseases,and the study on its intervention thresholds,which lays a foundation for clinicians to understand the research progress of FRAX and to explore the intervention threshold for Chinese population.