亚洲骨质疏松自我评价工具与中国骨质疏松筛查工具筛检效果比较.docVIP

亚洲骨质疏松自我评价工具与中国骨质疏松筛查工具筛检效果的比较 　　摘要：目的： 比较亚洲骨质疏松自我评价工具（osteoporosis self-assessment tool for Asians，OSTA）与中国大陆地区绝经后妇女骨质疏松症自我筛查工具（osteoporosis screening tool Chinese， OSTC）筛检效果，评估其临床应用价值。方法： 2013年11月～2014年3月纳入292名50周岁以上绝经后妇女，应用双能X线骨密度仪测量受试者腰椎及左侧股骨近端骨密度数据，利用体重和年龄计算OSTA指数、OSTC指数，并进行比较。结果：OSTA指数、OSTC指数与腰椎及骨股颈骨密度呈正相关（r=0.448，r=0.584，P0.001和r=0.430，r=0.623 ，P0.001）。按两级风险程度分类界值判定，OSTA和OSTC的敏感度分别为60.0%、92.7%；特异度75.9%、37.1%；阳性预测值 36.6%、25.5%；阴性预测值 89.1%、95.7%；Youden指数 35.9%、29.8；ROC曲线下面积AUC分别为0.769（95%[CI] 0.705-0.833）、0.760（95%[CI] 0.697-0.823）0.760（0.697，0.823）。结论： OSTC的敏感度优于OSTA，但是其特异度劣于OSTA，不推荐单独应用作为绝经后妇女骨质疏松症的早期筛查工具。 　　关键词：骨质疏松症；中国骨质疏松筛查工具；筛检效果；骨密度 　　Abstract：Objective To assess the clinical value of two screening toolsComparison of Screening capability between osteoporosis self-assessment tool for Asians and osteoporosis screening tool Chinese. Methods Bone mineral density at lumbar spine， femoral neck were measured by DXA of 292 postmenopause women aged over 50 years old from November 2013 to March 2014.OSTA and OSTC risk indexes of each one were calculated on the basis of their weight and age， and were compared. Results The bone mineral density of both were correlated positively with OSTA indexes and OSTC（r=0.448，r=0.584，P0.001和r=0.430，r=0.623 P0.001）.According to the two risk levels， OSTA and OSTC indexes could diagnose osteoporosis with the sensitivity of 60.0% and 92.7%，the specificity of 75.9% and 37.1%，the positive predictive value of 36.6%、25.5%，the ？negative predictive value of 89.1%、95.7%，the area under ROC curve of 0.769（95%[CI] 0.705-0.833） and 0.760（95% confidence interval from 0.697 to 0.823） ，respectively. Conclusion OSTC sensitivity is better than that of OSTA， but its specific degree is inferior to OSTA， so it is not recommended as early screening tool for postmenopausal osteoporosis alone.1 　　Keywords：Bone mineral density；Osteoporosis；Osteoporosis screening tool； Clinical application 　　随着社会人口老龄化的到来，我国骨质疏松症（osteoporosis，OP）的患病率正日益增加，骨质疏松症和骨质疏松骨折已