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骨质与患有血红蛋白病变的患者的脆弱性骨折有关
Ellen B Fung1, Iman Sarsour2, Raquel Manzo3
1Division of Hematology, Department of Pediatrics, University of California, San Francisco, USA.
概括
脊椎骨分数 (TBS) 有效地预测了患有血病 (Thal) 和状细胞病 (SCD) 的成年人的脆弱性骨折. 异常TBS与脆弱性骨折有很强的相关性,为这些患者群体的风险评估提供了有价值的工具.
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
- 放射学 放射学是一门学科.
背景情况:
- 患有thalassemia (Thal) 和状细胞疾病 (SCD) 的成年人经常经历低骨质量 (BMD Z-score ≤-2.0).
- 疾病特定的人工物可能会损害这些患者骨矿物质密度 (BMD) 评估的准确性.
- 脊椎骨评分 (TBS) 评估骨质量,不受文物的影响,可能改善骨折风险预测.
研究的目的:
- 评估状骨评分 (TBS) 在预测患有沙拉西米亚和状细胞病患者的脆弱性骨折方面的有用性.
- 为了比较血红蛋白病症患者和健康对照者之间的骨折患病率和风险因素.
- 评估异常TBS与脆弱性骨折的关联,独立于骨矿物质密度 (BMD) 和其他临床因素.
主要方法:
- 对于经过脊椎BMD扫描的Thal或SCD患者的回顾性图表审查.
- 使用TBS (不正常定义为TBS <1.2) 检查骨质的BMD扫描的重新分析.
- 根据患者报告和医疗记录验证确定骨折患病率;与健康对照进行比较.
主要成果:
- 与对照组 (0%) 相比,Thal (26%) 和SCD (7%) 的患者中异常TBS的患病率明显高于对照组 (0%).
- 骨折患病率在Thal (36%) 和SCD (23%) 中高于对照组 (16%).
- 异常的TBS强烈预测脆弱性骨折 (OR:11.4),而低的BMD在调整后没有预测脆弱性骨折.
结论:
- 在患有血红蛋白病变的年轻人中,TBS是预测脆弱性骨折风险的宝贵工具.
- 在管理低BMD和骨折风险的患者时,应考虑TBS评估,特别是当BMD因疾病人工物而混时.
- 异常的TBS是脆弱性骨折的重要预测因素,在这种情况下,其表现优于传统的BMD.
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