血液造血干细胞移植后骨折的特征和预测因素
Hsin-Lin Tsai1,2,3, Tzu-Ching Lin2,4, Hui-Hsin Yang1,2
1Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112201, Taiwan.
The Journal of clinical endocrinology and metabolism
|January 23, 2024
概括
血造干细胞移植 (HSCT) 接受者有先前的骨折和高剂量类固醇使用面临骨折风险增加. 早期查和预防措施对于这些患者的骨健康至关重要.
科学领域:
- 血液学 血液学 血液学
- 整形外科 整形外科 整形外科
- 移植医学 移植医学
背景情况:
- 骨损失和骨折是血造干细胞移植 (HSCT) 后的重大并发症.
- 在HSCT接受者中识别骨折风险预测因素是具有挑战性的.
- 之前对亚洲HSCT接受者骨折风险的基于人口的研究缺乏.
研究的目的:
- 为了确定HSCT接受者的骨折发生率.
- 为了确定与移植后骨折相关的风险因素.
主要方法:
- 使用台湾国家医疗保险研究数据库 (2003-2015) 进行的回顾性队列研究.
- 包括接受HSCT的18岁以上的患者.
- 通过ICD-9-CM代码识别骨折,并使用Cox回归进行风险因素分析.
主要成果:
- 共有3327名患者接受HSCT,其中126名 (3.8%) 患有骨折.
- 累积骨折发生率在5年达到5.3%,在10年达到10.8%.
- 之前的骨折 (HR=3.79) 和日益增加的普雷尼索隆剂量 (HRs从1.70到2.93) 显著增加了骨折风险.
结论:
- 具有骨折史的HSCT接受者和服用大量类固醇剂量的患者需要早期查骨质损失.
- 对高风险个体来说,就骨损失的预防措施进行咨询是必不可少的.
- 这项研究提供了关于亚洲HSCT人群中骨折发生率和风险因素的关键数据.
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