在初级保健中评估骨质疏松症时,例行实验室检查的产量
Thomas Merlijn1, Karin M A Swart2, Christy Niemeijer3
1Department of General Practice, Amsterdam UMC, Amsterdam, The Netherlands. t.merlijn@merlijnenvandoorn.zorgring.nl.
概括
老年妇女的常规实验室测试显示,异常的患病率很低,对骨折风险的临床影响有限. 大多数异常发现并没有导致新的诊断或治疗.
科学领域:
- 老年学是一门学科.
- 主要护理医学 医疗保健
- 临床病理学 临床病理学
背景情况:
- 骨质疏松症指南经常建议老年妇女进行例行实验室检查.
- 这些测试在初级保健机构中骨折风险评估中的临床实用性需要进一步研究.
研究的目的:
- 评估在初级保健机构中评估老年妇女骨折风险时常规实验室检查的效果.
- 为了确定实验室异常的患病率及其与骨折风险因素,骨矿物质密度和骨折的关联.
主要方法:
- 一项前性研究,涉及8996名65岁及以上的妇女,参加初级保健骨折风险查计划.
- 评估实验室异常,骨矿物质密度 (BMD),骨折史,以及对2208名参与者的亚组中临床后果的随访医疗记录.
主要成果:
- 维生素D缺乏 (13%) 和不足 (43%) 是很常见的. 其他实验室异常是罕见的 (2.6%-6.1%) 和弱相关的低BMD,但没有脊椎或最近的骨折.
- 大多数确定的实验室异常 (82%) 在随访期间没有导致新的诊断或治疗.
结论:
- 在老年妇女的初级保健中,例行实验室检查显示,异常的患病率很低,对骨折风险的临床意义有限.
- 这些发现表明,在这个人群中,常规使用实验室测试可能对骨折风险评估没有很大的益处.
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