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首页> 美国卫生研究院文献>Canadian Medical Association Journal >Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 2. The use of bone density measurement in the diagnosis and management of osteoporosis.
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Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 2. The use of bone density measurement in the diagnosis and management of osteoporosis.

机译：骨质疏松症的预防和管理：加拿大骨质疏松症学会科学顾问委员会的共识声明。 2.骨密度测量在骨质疏松症的诊断和管理中的应用。

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OBJECTIVE: To determine the best method of diagnosing osteoporosis and determining fracture risk and to promote standards in the use of bone densitometry and the reporting of results. OPTIONS: Methods of bone mineral density measurement: dual-energy x-ray absorptiometry (DXA), radiographic absorptiometry, single-photon absorptiometry, dual-photon absorptiometry, quantitative computed tomography, quantitative ultrasound, neutron activation analysis. The options of using bone densitometry in individual patient management and as a mass screening tool are also considered. OUTCOMES: Appropriate use of densitometry to promote accurate diagnosis and assessment of fracture risk and timely, appropriate treatment. EVIDENCE: Relevant clinical studies and reports were examined. Clinical practice in Canada was also considered. VALUES: Accurate assessment of osteoporotic fracture risk and diagnosis of osteoporosis and assuring low exposure to medical radiation were given a high value. BENEFITS, HARMS AND COSTS: Early diagnosis through bone density measurement allows proper management of osteoporosis to minimize injury and disability, improve quality of life and reduce the personal and social costs associated with the condition. Potential harms include radiation exposure and cost. The harms and costs of appropriate use of DXA are minimal compared with the harms and costs associated with osteoporosis. RECOMMENDATIONS: Bone mineral density should be measured only to assist in making a clinical management choice. DXA is the best method of measuring bone density and, thus, the best available indicator of osteoporotic fracture risk. Plain radiographs may supplement DXA if there is a specific reason for their use. Measurement of the lumbar spine and femoral neck is standard, but a different site or a single measurement is recommended in specific cases. Unless accelerated bone loss is suspected, DXA should be repeated every 2 to 4 years for patients receiving ovarian hormone therapy and 1 to 2 years for patients undergoing bisphosphonate therapy. Measurements and reporting of results must be standardized. Reports should refer to the World Health Organization's recommended definitions of osteopenia and osteoporosis and provide actual measurement and its relation to peak bone mass.
机译：目的：确定诊断骨质疏松症和确定骨折风险的最佳方法，并提高使用骨密度测定法和报告结果的标准。选项：骨矿物质密度测量方法：双能X射线吸收法（DXA），放射线吸收法，单光子吸收法，双光子吸收法，定量计算机断层扫描，定量超声，中子活化分析。还考虑了在个别患者管理中使用骨密度测定法以及作为大众筛查工具的选择。结果：适当使用光密度测定法可促进对骨折风险的准确诊断和评估以及及时，适当的治疗。证据：检查了相关的临床研究和报告。还考虑了加拿大的临床实践。价值：对骨质疏松性骨折风险的准确评估和对骨质疏松症的诊断以及确保低暴露于医学辐射的评估具有很高的价值。优势，危害和成本：通过骨密度测量的早期诊断可以对骨质疏松症进行适当管理，以最大程度地减少伤害和残疾，改善生活质量，并减少与该病症相关的个人和社会成本。潜在危害包括辐射暴露和成本。与骨质疏松症相关的伤害和费用相比，适当使用DXA的伤害和费用是最小的。建议：仅应测量骨矿物质密度以帮助做出临床管理选择。 DXA是测量骨密度的最佳方法，因此是骨质疏松性骨折风险的最佳可用指标。如果有特殊原因，普通X射线照片可能会补充DXA。腰椎和股骨颈的测量是标准的，但是在特定情况下，建议不同的部位或进行一次测量。除非怀疑骨质加速流失，否则接受卵巢激素治疗的患者应每2至4年重复DXA，接受双膦酸盐治疗的患者应每1至2年重复DXA。测量和结果报告必须标准化。报告应参考世界卫生组织对骨质减少和骨质疏松症的建议定义，并提供实际测量值及其与峰值骨量的关系。

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