中老年居民骨质疏松高危人群筛查方法研究

目的探索适合江苏省中老年居民骨质疏松高危人群的筛查方法。方法 2013年采用多阶段分层随机抽样方法,在江苏省内抽取40~69岁常住居民,利用国际骨质疏松基金会(IOF)1分钟风险评估调查问卷和桡骨远端超声骨密度检查,进行骨质疏松高危人群筛查。结果有效调查5 537人,有效率为98.8%。骨质疏松高危人群检出率:1分钟问卷风险评估法为44.0%,桡骨远端超声骨密度检查法为42.4%,差异有统计学意义(χ2=17.53,P0.001)。2种方法筛查结果一致性较差,Kappa系数及其95%可信区间为0.048(0.022~0.074)。随着年龄的增加,骨质疏松高危人群检出率呈上升趋势,且存在地区差异(P0.05)。结论 1分钟问卷风险评估和桡骨远端超声骨密度检查法均可作为社区中老年人群骨质疏松筛查工具,但一致性较差,实际工作中建议联合运用,以便互相补充和验证。

Research on screening methods for high-risk osteoporosis populations in middle and elderly community residents

Objective To study screening methods for high-risk osteoporosis populations in middle and elderly community residents.Methods Multi-stage stratified random sampling method was used to select permanent residents aged 40~69as survey subjects.High-risk populations of osteoporosis were surveyed by One-minute Osteoporosis Risk Assessment questionnaire of International Osteoporosis Foundation（IOF）and screened by ultrasonic distal radius bone density.Results A total of 5 537residents were surveyed effectively,resulting effective survey rate of 98.8%.Detection rate of osteoporosis was 44.0% and 42.4%in high risk osteoporosis populations using One-minute Osteoporosis Risk Assessment Questionnaire and ultrasonic bone mineral density examination,respectively,with significant difference（χ2=17.53,P〈.001）.Consistency of 2methods was poor;Kappa coefficient was 0.048and 95%confidence limit was 0.022~0.074.Detection rate increased with age,while significant difference was observed among regions（P〈.05）.Conclusion One-minute Osteoporosis Risk Assessment Questionnaire and distal radius ultrasonic bone density examination can both be used in community population-based screening for middle and elderly residents,while the consistency of the 2methods was poor.Combined uses of 2methods were suggested in routine work to achieve complement and mutual validation.