社区绝经后妇女骨质疏松症筛查结果及影响因素研究

目的 分析社区绝经后妇女骨质疏松症筛查结果及影响因素，评价亚洲绝经后妇女骨质疏松自我筛查(osteoporosis self-assessment tool for Asians,OSTA)指数评分对绝经后妇女骨质疏松风险的预测能力，为同行开展社区骨质疏松症相关人群识别提供经验借鉴。 方法 以2019年3—4月期间在上海市浦东新区曹路社区卫生服务中心参加骨质疏松筛查的5 191名绝经后妇女为研究对象。采用调查问卷结合跟骨超声骨密度检测进行骨质疏松筛查。采用SPSS 24.0统计学软件进行数据分析。 结果 5 191名绝经后妇女中，1 502人(28.93%)有中级及以上骨质疏松风险，且跟骨超声结果显示，1 280人(24.66%) T值≤-2.0。年龄越大、BMI越小、OSTA评分越低，T值越低(均P＜0.05)，有无低体重、脆性骨折史、腰背部疼痛、跌倒史、帕金森、子宫及卵巢癌以及骨松风险分级不同，跟骨超声测量出的T值差异有统计学意义(均P＜0.05)。OSTA评分是否≤-1，与跟骨超声测出的T值是否≤-2.0，有较差的一致性(Kappa=0.197<0.4，P＜0.05)。 结论 社区骨质疏松风险人群的识别，可将OSTA评估、跟骨超声，与BMI或低体重、脆性骨折史、腰背部疼痛、跌倒史、帕金森、子宫及卵巢癌等个人健康并既往病史情况结合使用。 

Screening results and influencing factors of osteoporosis in postmenopausal women in community

Objective To analyze the results and influencing factors of osteoporosis screening in postmenopausal women, and to evaluate the predictive power of OSTA scores on the risk of osteoporosis in postmenopausal women, so that to provide experience for peers to identify community-related osteoporosis. Methods A total of 5 191 postmenopausal women who participated in osteoporosis screening at Caolu Community Health Service Center in Pudong New Area, Shanghai were enrolled from March to April 2019. Osteoporosis screening was performed using a questionnaire combined with calcaneus bone mineral density by quantitative ultrasound system. Data analysis was performed using SPSS 24.0 software. Results Of the 5 191 postmenopausal women, 1 502 (28.93%) had intermediate and higher risk of osteoporosis, and the results of calcaneus ultrasound showed that the number of people whose T value ≤ -2 reached 1 280 (24.66%). The older the age, the smaller the BMI and the lower the OSTA score, the lower the T value (P<0.05). Whether the postmenopausal women were with low body weight, fragility fracture history, low back pain, history of falls, Parkinson's, uterus and ovarian cancer or not, and different osteoporosis risk rank, and the difference in T values measured by calcaneus ultrasound was statistically significant (P<0.05). Whether the OSTA score was ≤ -1, and whether the T value measured by the ultrasound of the calcaneus was ≤ -2, there was a poor consistency (Kappa=0.197<0.4, P<0.05). Conclusion The identification of community osteoporosis risk population could be evaluated by OSTA assessment, calcaneus ultrasound, in conjunction with other personal health history such as BMI or low body weight, fragility fracture history, low back pain, history of falls, Parkinson's, uterus and ovarian cancer.