文章摘要
苏琳,李金康,张鑫.超声定量参数结合骨折风险预测简易工具预测绝经后骨质疏松症病人骨折风险[J].安徽医药,2024,28(6):1130-1134.
超声定量参数结合骨折风险预测简易工具预测绝经后骨质疏松症病人骨折风险
Prediction of fracture risk in postmenopausal osteoporosis patients by quantitative ultrasound parameters combined with fracture risk assessment tool
  
DOI:10.3969/j.issn.1009-6469.2024.06.015
中文关键词: 骨质疏松,绝经后  骨质疏松性骨折  超声声速  信号强度  宽带超声衰减  骨折风险预测简易工具
英文关键词: Osteoporosis, postmenopausal  Osteoporotic fractures  Speed of sound  Signal intensity  Broadband ultrasound attenuation  Fracture risk assessment tool
基金项目:
作者单位
苏琳 河南省直第三人民医院超声科河南郑州 450000 
李金康 河南省直第三人民医院超声科河南郑州 450000 
张鑫 河南省直第三人民医院超声科河南郑州 450000 
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中文摘要:
      目的探讨超声定量参数结合骨折风险预测简易工具( FRAX)对绝经后骨质疏松症( OP)病人骨折风险的预测效能。方法选取河南省直第三人民医院 2020年 1月至 2021年 10月收治的绝经后 OP病人 139例和绝经后健康志愿者 141例,分别记为疾病组与对照组。两组均采用超声检查并进行 FRAX评价。比较两组超声定量参数[包括超声声速( SOS)、信号强度( SI)和宽带超声衰减( BUA)]、 FRAX结果、双能 X线骨密度仪测量结果骨密度 T分值( T-score)、随访 1年内的骨折发生率。绘制受试者操作特征曲线( ROC曲线)分析超声定量参数结合 FRAX对病人骨折风险的预测效能,并与 T-score比较。结果疾病组 SOS、 SI、BUA和 T-score均低于对照组[( 1 496.45±70.25)m/s比( 1 569.83±79.98)m/s,(64.32±11.06)%比( 90.08±9.85)%,(51.38±7.02) dB/MHz比( 71.65±9.12)dB/MHz,(2.85±0.17)SD比( 0.62±0.11)SD](P<0.05), FRAX(4.05±0.71比 0.85±0.17)和骨折发生率(19.42%比 2.84%)均高于对照组(均 P<0.05);疾病组骨折发生病人年龄、身体质量指数(BMI)均高于骨折未发生病人, OP病程长于骨折未发生病人(均 P<0.05);疾病组骨折发生者 SOS、SI、BUA和 T-score均低于骨折未发生者[( 1 348.82±69.85)m/s比(1 532.04±74.63)m/s,(40.68±8.39)%比( 70.02±10.25)%,(35.33±6.01)dB/MHz比( 55.25±8.16)dB/MHz,( 3.85±0.19)SD比(2.61±0.10)SD],FRAX高于骨折未发生者( 8.99±1.05比 2.86±0.53)(均 P<0.05);超声定量参数联合 FRAX预测疾病组骨折发生的灵敏度均高于单独预测、 T-score预测,曲线下面积( AUC)也高于单独预测、 T-score预测( P<0.05),特异度高于 T-score预测。结论绝经后 OP病人超声 SOS、SI、BUA下降, FRAX结果和骨折风险升高,且超声 SOS、SI、BUA结合 FRAX可预测骨折风险,且优于 T-score预测。
英文摘要:
      Objective To explore the predictive efficacy of quantitative ultrasound parameters combined with fracture risk assess ment tool (FRAX) for fracture risk in postmenopausal osteoporosis (OP) patients.Methods A total of 139 postmenopausal OP patientsand 141 postmenopausal healthy volunteers admitted to The Third People's Hospital of He'nan Province from January 2020 to October2021 were enrolled and recorded as disease group and control group, respectively. Both groups were detected by ultrasound and evaluated by FRAX. The quantitative ultrasound parameters [including Speed of Sound (SOS), Signal Intensity (SI) and Broadband UltrasoundAttenuation (BUA)], FRAX results, detection results of dual-energy X-ray bone densitometer (T) and fracture incidences within 1-scoreyear's following-up were compared between the two groups. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive effect of quantitative ultrasound parameters combined with FRAX on patients' fracture risk, which was compared with T-score.Re sults The SOS, SI, BUA and Tin the disease group were lower than those of the control group [(1 496.45±70.25) m/s vs. (1 569.83±-score 79.98) m/s, (64.32±11.06)% vs. (90.08±9.85)%, (51.38±7.02) dB/MHz vs. (71.65±9.12) dB/MHz, (2.85±0.17) SD vs. (0.62±0.11) SD] (P<0.05), and FRAX (4.05±0.71 vs. 0.85±0.17) and incidence of fractures (19.42% vs. 2.84%) were higher than those of the control group, and the differences had statistical significance (P<0.05). The age and body mass index (BMI) of patients with fractures in the disease group were higher than those without fractures, and the duration of OP was longer than that of patients without fractures, and thedifferences had statistical significance (P<0.05). In the disease group, the SOS, SI, BUA and Tof patients with fractures were lower-score than those without fractures [(1 348.82±69.85) m/s vs. (1 532.04±74.63) m/s, (40.68±8.39)% vs. (70.02±10.25)%, (35.33±6.01) dB/MHz vs. (55.25±8.16) dB/MHz, ( 3.85±0.19) SD vs. (2.61±0.10) SD], and FRAX was higher than those without fractures (8.99±1.05 vs. 2.86±0.53), and the differences had statistical significance (P<0.05). The sensitivity of ultrasound quantitative parameters combinedwith FRAX to predict fractures in disease group was higher than those of single prediction and T, as well as the area under the curve-score(AUC), and the differences had statistical significance (P<0.05), and the specificity was higher than that of T-score.Conclusion In postmenopausal OP patients, ultrasound SOS, SI, BUA decrease, FRAX result and fracture risk increase, and ultrasound SOS, SI, BUAcombined with FRAX can predict fracture risk, which is better than that of T-score.
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