两种骨质疏松自我评价工具应用于围绝经期和绝经后妇女的筛检效果比较

【】　目的　评价亚洲骨质疏松自我评价工具（OSTA）和我国妇女骨质疏松筛选工具（OSTC）与四川地区围绝经期和绝经后汉族妇女骨密度的关系，比较两种工具对骨质疏松症的筛检能力，探讨其临床应用价值。　方法　2010年7―10月筛选获得356名45岁以上妇女的双能X线骨密度仪腰椎、股骨颈和全髋骨密度数据，利用体重和年龄分别计算OSTA指数与OSTC指数，并进行比较。　结果　OSTA指数与OSTC指数和各部位骨密度值均呈正相关（r=0.458~0.593和r=0.440~0.599，P<0.001），两种筛选指数之间呈正相关（r=0.956，P<0.001）。按两级危险程度分类界值进行判定，OSTA和OSTC的灵敏度分别为78.2%、93.5%，特异度为67.2%、43.0%，受试者工作特征曲线下面积为0.792、0.798，Kappa系数为0.452、0.357。　结论　OSTA与OSTC应用于四川地区围绝经期和绝经后妇女骨质疏松症的筛查效果均不理想，临床应用价值受限。【Abstract】　Objective　Toevaluatetherelationshipbetweenosteoporosisself-assessmenttoolforasians(OSTA),osteoporosisself-assessmenttoolforAsians(OSTC)andbonemineraldensityinSichuanperimenopausalandpostmenopausalwomenofHannationality,anddiscussthevalueoftheirclinicalapplicationthroughcomparisonofthescreeningabilityofthetwotoolsinpredictingosteoporosisandlowbonemass.　Methods　Withthedataofbonemineraldensityatlumbarspine,femoralneckandtotalproximalfemurmeasuredbyDXAof356womenaged45yearsoldandabove,OSTAandOSTCriskindexesofeachsubjectwerecalculatedbasedontheirweightandage,andwerethencompared.　Results　Thebonemineraldensityofabove-mentionedlocationswerepositivelycorrelatedwithOSTAandOSTCindexes(r=0.458-0.593andr=0.440-0.599,P<0.001),andthesetwoindexeswerealsocorrelatedpositively(r=0.956,P<0.001).Accordingtothetworisklevelsbythesecutoffs,OSTAandOSTCindexescoulddiagnoseosteoporosiswiththesensitivityof78.2%and93.5%,thespecificityof67.2%and43%,theareaunderROCcurveof0.792and0.798,andtheKappavalueof0.452and0.357,respectively.　Conclusion　BothOSTAandOSTCwerenotidealtoolsforscreeningosteoporosisinperimenopausalandpostmenopausalwomeninSichuanprovince.