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【medical-news】绝经后骨质疏松的妇女是否需行脊
Release Date: January 9, 2007; Valid for credit through January 9, 2008
January 9, 2006 — Six clinical parameters provide adequate data to justify spine radiography to determine vertebral fractures in osteoporotic postmenopausal women presenting with back pain, according to the results of a study reported in the January issue of Annals of the Rheumatic Diseases.
"Vertebral fractures are underdiagnosed, although the resulting mortality and morbidity in postmenopausal women with osteoporosis is now recognized," write C. Roux, MD, from the Université Paris-Descartes, Hôpital Cochin in Paris, France, and colleagues. "Because of both radiation concerns and cost, spine radiography cannot be used to screen all women with osteoporosis. It is possible to optimise the selective use of spine radiography using an index based on age, height loss and history of fracture."
The investigators interviewed, examined, and performed spine radiography on 410 postmenopausal women with osteoporosis who consulted a rheumatologist for back pain. Average age was 74 years. Of the 410 women, 215 (52.4%) were diagnosed with at least 1 vertebral fracture. Logistic regression was used to identify the most relevant clinical factors predicting vertebral fractures on spine radiography.
The 6 parameters that were the best predictors of vertebral fracture were age, back pain intensity, height loss, history of low-trauma nonvertebral fractures, thoracic localization of back pain, and sudden occurrence of back pain. On a scoring system or quantitative index with a maximal score of 16, a score of 7 was associated with a 43% probability of existing vertebral fracture. The correlation between this quantitative index and the logistic model probability was 0.98, reflecting an accurate and highly significant approximation of the original prediction equation.
Study limitations were exclusion of bone mineral density from the index, small sample size, and lack of validation of the scoring system in another population.
"From six clinical items, an index was built to identify women with osteoporosis and back pain who should have spine radiography," the authors write. "This simple tool may help clinicians to optimise vertebral fracture diagnosis and to make a proper therapeutic decision."
The authors have disclosed no relevant financial relationships.
Ann Rheum Dis. 2007;66:81-85.
http://www.medscape.com/viewarticle/550513 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 楼上超时，本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Clinical Tool Determines Need for Spine X-Ray in Osteoporotic Postmenopausal Women
判断绝经后骨质疏松的妇女是否需行脊柱X线检查的临床方法
January 9, 2006 — Six clinical parameters provide adequate data to justify spine radiography to determine vertebral fractures in osteoporotic postmenopausal women presenting with back pain, according to the results of a study reported in the January issue of Annals of the Rheumatic Diseases.
2006年1月9日 根据《风湿病年鉴》1月份期刊的一份研究报告，六个临床指标可以提供足够数据来判断伴有背痛的绝经后骨质疏松妇女是否有必要进行脊柱X射线检查，从而确认是否发生椎骨骨折。
"Vertebral fractures are underdiagnosed, although the resulting mortality and morbidity in postmenopausal women with osteoporosis is now recognized," write C. Roux, MD, from the Université Paris-Descartes, Hôpital Cochin in Paris, France, and colleagues. "Because of both radiation concerns and cost, spine radiography cannot be used to screen all women with osteoporosis. It is possible to optimise the selective use of spine radiography using an index based on age, height loss and history of fracture."
来自法国巴黎Paris-Descartes大学Cochin医院C. Roux博士说：“虽然绝经后骨质疏松妇女的椎骨骨折的发病率和致死率现在被意识到，但是诊断率低。因为放射损害以及费用的关系，脊柱X射线并不能应用于所有骨质疏松妇女。现在可以采用基于年龄、身高降低以及骨折史的综合指标来合理判断是否使用脊柱X射线进行诊断。
The investigators interviewed, examined, and performed spine radiography on 410 postmenopausal women with osteoporosis who consulted a rheumatologist for back pain. Average age was 74 years. Of the 410 women, 215 (52.4%) were diagnosed with at least 1 vertebral fracture. Logistic regression was used to identify the most relevant clinical factors predicting vertebral fractures on spine radiography.
研究者经接诊、检查，对向风湿病专家咨询背痛的绝经后骨质疏松妇女中的410位患者实行脊柱X射线检查。这些患者平均年龄74岁。在410位患者中，215位患者（52.4％）被诊断至少1处椎骨骨折。通过Logistic回归分析，选择最相关的临床指标来预测脊柱X射线检查椎骨骨折情况。
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作者:admin@医学,生命科学 2011-10-28 05:46
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