111 CurrentsituationoftheadministrationofosteoporosisinChineseclinicians QIXuan 1,WANGOu 1,FUQin 2,TANGHai 3,CHENJin ping 4,WANGLiang 5,JIAXue feng 6,

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1 110 DOI: /j.isn Z[ ' *4\]^_`a#bc 漆璇 1, 王鸥 1, 付勤 2, 唐海 3, 陈锦平 4, 王亮 5, 贾雪峰 6, 兰林 7, 雷晨 8, 魏永军 9, 胡永军 10, 宫树一 11, 邓忠良 12, 徐又佳 13, 郭晓东 14, 袁光华 15, 薛庆云 16, 刘昊楠 17, 夏维波 1 18, 徐苓 [] I ' * 4\]^_`a#bc, * H4\]^, " )*_` 4\]^ H Z 4\]^ *, '? 30~ *, '4 ( * 4\]^ X (dual energyx rayabsorptiometry, DXA) 4, * * ( 81 3% 90 2%, 89 1% 95 5%);4 (96 9%) ( (98 2%) * DXA * (89 4%) / * D (selectiveestrogenreceptor modulators,serms) +" B (P<0 05), ( * D J J, ' (54 5%) 4\]^a #, * 4 \ ] ^ H a # a # 30%, (16 5%) 4 * (21 9%)a# 30% $, H4\]^!$ $ " 4 ( '4\]^ H# $%& * ', 17 * 4\]^!$_` ( ) *, +4\]^ H 5 [ ] 4\]^ ; *; :R681!"#$:A : (WBYZ );! " ( ) #$%&: ,' " " " ( )* +,*-./0 ( 1 ; ,' " ; ,67 " ; :;, 4 ; , <=> '?4 ; @, A BC>5 4 ; D;, D D;E' 4 ; , " ( ; E, F G H I E J K C 4 ; L, L M N I 4 ; , 4 O ; L,L " 2> 4 ; D;, D D; " 2> 4 ; A,@' " P " 2 4 ; A,Q A RSI 4 ; ,)* +,*-./0 4 ; , TUV WXY ; ,' " " " #$:,E mail:wang_ou2010@126.com

2 111 CurrentsituationoftheadministrationofosteoporosisinChineseclinicians QIXuan 1,WANGOu 1,FUQin 2,TANGHai 3,CHENJin ping 4,WANGLiang 5,JIAXue feng 6, LANLin 7,LEIChen 8,WEIYong jun 9,HUYong jun 10,GONGShu yi 11,DENGZhong liang 12,XUYou jia 13, GUOXiao dong 14,YUANGuang hua 15,XUEQing yun 16,LIUHao nan 17,XIAWei bo 1,XuLing 18 1 DepartmentofEndocrinology,KeyLaboratoryofEndocrinology,MinistryofHealth,PekingUnionMedicalColege Hospital,ChineseAcademyofMedicalScience&PekingUnionMedicalColege,Beijing100730,China;2 Department oforthopaedics,shengjinghospitalofchinamedicaluniversity,shenyang110004,china;3 DepartmentofOrthopae dics,beijingfriendshiphospital,capitalmedicaluniversity,beijing100050,china;4 DepartmentofOrthopaedics, People shospitalofzhejiang,hangzhou310014,china;5 DepartmentofOrthopaedics,The309thHospitalofPLA, Beijing100091,China;6 DepartmentofOrthopaedics,WuyiFirstPeople shospital,wuyi321200,zhejiang,china; 7 DepartmentofOrthopaedics,WuzhongPeople shospitalofsuzhou,wuzhong215128,jiangsu,china;8 Department ofendocrinology,generalhospitalofningxiamedicaluniversity,yinchuan750004,china;9 DepartmentofOrthopae dics,yanchihospital,wuzhong751500,ningxia,china;10 DepartmentofOrthopaedics,BananPeople shospitalof Chongqing,Chongqing401320,China;11 DepartmentofSpineSurgeryShenyangOrthopedicsHospital,Shenyang ,China;12 DepartmentofOrthopaedics,TheSecondHospitalAfiliatedtoChongqingMedicalUniversity, Chongqing400010,China;13 DepartmentofOrthopaedics,TheSecondHospitalAfiliatedtoSuzhouUniversity,Suzhou ,Jiangsu,China;14 DepartmentofOrthopaedics,UnionHospitalAfiliatedtoTongjiMedicalColege,Hua zhonguniversityofscienceandtechnology,wuhan430022,china;15 DepartmentofOrthopaedics,XinzhouDistrict People shospitalofwuhan,wuhan430400,china;16 DepartmentofOrthopaedics,BeijingHospital,Beijing100005, China;17 Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital, Beijing , China; 18 DepartmentofObstetricsandGynecology,PekingUnionMedicalColegeHospital,ChineseAcademyofMedicalSci ences&pekingunionmedicalcolege,beijing100730,china [Abstract] Objective Toinvestigatethepresentsituationoftheparticipationinosteoporosisofcliniciansfrom diferentdepartments,diferentgradesofhospitalsanddiferentareas,andtoprovideevidencetoformulateandconsum matethepreventionandtreatmentstrategyofosteoporosis.methods Anaverageof30-35cliniciansofdiferentdepart mentswhicharerelatedtothepreventionandtreatmentofosteoporosisfrom17hospitalsparticipatedinthesurveyvoluntari ly.abeforehanddesignedquestionnairewasusedinthisstudy.results Totaly568cliniciansfromeleven3 A gradehos pitalsandsix2 gradehospitalsfinishedthequestionnaire,amongwhichcliniciansfromtheorthopaedicsandendocrinology departmentwereinthemajority.doctorsfrom3 A gradehospitalshadahigherawarenesofwhethertheirhospitalhadoste oporosisclinicanddual energyx rayabsorptiometry(dxa)whencomparedwiththedoctorsfrom2 gradehospitals.clini ciansfromalthedepartmentshadasimilarawarenesofwhethertheirhospitalhadcalcium/vitamindandselectiveestro genreceptormodulators(serms).doctorsfromdepartmentofendocrinologyhadahigherawarenesaboutactivatedvita mind,bisphosphonates,calcitonin,estroged,andstrontiumranelatethanothers.theobstetriciansandgynecologistshad alowerawarenesoftraditionalchinesemedicine.investigationconcerningtheparticipationdegreeintheworkrelatedtoos teoporosisofalthedoctorsshowedthat,inmostofthem,workrelatedtoosteoporosisonlytookuplesthan30% ofal theirclinicalwork.therateofdoctorswashigherin3 A gradehospitalsandinorthopedistwhoseworkproportionrelatedto osteoporosiswashigherthan30% ofaltheirclinicalwork.conclusiontheresultsofthisstudyshowedthedefectsinthe preventionandtreatmentofosteoporosis,includinglackofexaminingequipment,thelowawarenesandparticipationde greeoftheclinicians.thisstudyalsocolectedsomeopinionsandadvisesoftheadministrationcorcerningpatientswithoste oporosisfromtheclinicians.thismayprovidesomeevidencefortheformulationandconsummationofthepreventionand treatmentstrategyofosteoporosis. [Keywords] osteoporosis;clinicians;survey

3 112 4\]^ : 4; : -. [1], < 4;0=>?!$ * \,@A67 ' B-,=CD'E 1 FG H 'F GI 04\]^ H'JKLM <N 4\]^ 'JKL,2006 1' 50O '!4\]^ $ 6944, 50O 19 84%; 4 $ 21390, 61 11% [2] 4\]^H bc,eliot Gibson [3] P QR!$STU<* 4\ ]^ 4;,VW XY` 4\]^H, # H Y * D Z[' T '& 18%, 4\]^ T Z 10% Z[[ 2\Z +4\]^!$ 9 4; ( 4\] ^ ] Z 56 8%,30%^_!$W ` abc H, 40%! $ T / * D [4] *!$. 67 bc 5, Z[ I ' * 4\]^ 4\]^_`a#bc, * + H4\]^, " )*_` 4\]^ H %&' %& L A :; D; JK 7 17, 'c A , Z 4\]^ *, '? 30~35, << 600, c : (1) ( " ) (2) 4\]^ X (dual energyx rayab sorptiometry,dxa) 4 (3) RH 4\]^ :a / * D;b * D;c J;d ; e ;f (selective estrogen receptormodulator,serm);g J;h c ;i ' (4) 4\]^a # a# (>80% >50% 80% >30% 50% >10% 30% >5% 10% 5%),1 H4\]^!$ (>20 19~10 9~5 <5 ) (5) >? * 4\]^ HT :a -. ;b ;c ;d ;e ;f (6) 4\]^ H ):a -. ;b * ;c 4\]^,!$ X ;d ] $ (4 4 0 );e ( Z._` ); f (7) 4\]^a# *:a ;b * " - 4 ;c : 4\ ]^ ( " );d I $ H4\]^ ;e 4\]^ H'?;f 4\]^._`;g 4\]^ ;h 4\]^ Z ;i 4\]^ H P ;j 4\]^."Z[;k '?Y# Z[;l 4\]^ ] \ ;m SPSS22 0 +" +, [ χ 2, P<0 05 +" B ( 17 ', I 5

4 113, I \] ^, DXA;6 ' 2 4\]^,2 DXA 4\]^ ( ) c : / * D100% (17/17), * D94 1% (16/ 17), J 94 1% (16/17), 94 1% (16/17), 94 1% (16/17), SERM 47 1% (8/17),J 35 3% (6/17), c 47 1% (8/17),' 94 1% (16/17) 568 *, ' 375 (66%), 193 (34%) ' 76(13 4%) 165(29 0%) 157(27 6%) 170(29 9%), N" 1 1 )'*+,-./ 0 Fig1 Distributionofthespecializedfieldsofthe cliniciansparticipantinginthisresearch %1, (86 4%) * 4 \] ^,4 (86 3%) ( (93 0%) * * (85 1%), +" B (P=0 290); * (81 3%) (89 1%), +" B (P=0 011) 532 (93 7%) * DXA, '4 (96 9%) ( (98 2%) * * (89 4%), +" B (P=0 001) * DXA (90 2%) (95 5%), +" B (P=0 014) / * D (P=0 763) SERM (P=0 051) c (P= 0 055), +" B (P> 0 05); ( * D J J, ' (P<0 05)( 1) )' : \]^ Ha# a# >80% >50% 80% >30% 50% >10% 30% >5% 10% <5% * 7 (1 2%) 15 (2 6%) 55 (9 7%) 127 (22 4%) 151(26 6%) 213(37 5%), 30% ( 2) 30%, 4\ ]^ Ha# ; 1 /,-% 3 <=>?@A [n(%)] Table1 Awarenesrateoftheanti osteoporoticdrugsintheirhospitalinthecliniciansfrom diferentdepartments[n(%)] 4 ( P / * D 252(98 0) 57(100 0) 54(98 2) 196(98 0) 559(98 4) * D 213(83 2) 56(98 2) 50(90 9) 171(85 5) 490(86 3) J 197(77 0) 54(94 7) 36(65 5) 153(76 5) 440(77 5) (85 9) 56(98 2) 42(76 4) 170(85 0) 488(85 9) (63 7) 54(94 7) 43(78 2) 168(84 0) 428(75 4) SERM 161(62 9) 42(73 7) 32(58 2) 145(72 5) 380(66 9) J 157(61 3) 47(82 5) 36(65 5) 148(74 0) 388(68 3) c 163(63 7) 46(80 7) 32(58 2) 133(66 5) 374(65 8) ' 184(71 9) 44(77 2) 30(54 5) 145(72 5) 403(71 0) Y+ 256(45 1) 57(10 0) 55(9 8) 200(35 2) 568(100 0) SERM:

5 114 a# >30% B a# $, 4 \ ] ^ H a # $ (16 5%) (7 8%), + " B (P=0 004);4 * a # $ (21 9%) 4 * (6 7%), +" B (P=0 000) H4\]^!$ >20 19~10 9~5 <5 * 73(12 9%) 67(11 8%) 93(16 4%) 335(59 0%) H >10 H, 18 7%, 27 7%,, +" B (P= 0 017);4 (38 3%) H $ (10 6%); ( (26 3%) H $Z (10 6%), +" B (P=0 002)( 3) BC D 45E >? * 4\]^ HT, $ 303 (53 3%), -. $ 260 (45 8%), $ 254 (44 7%), $ 185 (32 6%), $92 (16 2%) 4\]^ H ),468 * (82 4%) -.,389 (68 5%) *, 348 (61 3%),295 (51 9%) 4 \ ] ^, 250 (44 0%) ] $ 4\]^ Ha# *,539 * (94 9%),498 (87 7%) * " - 4,479 (84 3%) : 4\ ]^,483 (85 0%) I $ H 4 \ ] ^, 482 (84 9%) 4\]^._`,492 (86 6%) 4\]^, ; 2 /,- D 45FG 0 [n(%)] Table2 Proportionofosteoporosis relatedtimeoccupiedintheworkofthecliniciansfrom diferent departments[n(%)] 4^ Ha# 4 ( Y+ >80% 5(2 0) 1(1 8) 0(0) 1(0 5) 7(1 2) >50% 80% 10(3 9) 1(1 8) 0(0) 4(2 05) 15(2 6) >30% 50% 41(16 0) 3(5 3) 3(5 5) 8(4 0) 55(9 7) >10% 30% 74(28 9) 16(28 1) 6(10 9) 31(15 5) 127(22 4) >5% 10% 65(25 4) 23(40 4) 12(21 8) 51(25 5) 151(26 6) <5% 61(23 8) 13(22 8) 34(61 8) 105(52 5) 213(37 5) Y+ 256(100 0) 57(100 0) 55(100 0) 200(100 0) 568(100 0) ; 3 /,-HI2 JKGA 0 [n(%)] Table3 Proportionofosteoporosispatientsnumberofthecliniciansfrom diferentdepartmentsdealswith inaweek[n(%)] H >20 19~10 9~5 <5 Y+ 17(8 8) 19(9 8) 26(13 5) 131(67 9) (14 9) 48(12 8) 67(17 9) 204(54 4) (22 3) 41(16 0) 46(18 0) 112(43 8) 256 ( 4(7 0) 11(19 3) 15(26 3) 27(47 4) 57 12(4 7) 15(5 9) 32(12 5) 196(76 9) 255 Y+ 73(12 9) 67(11 8) 93(16 4) 335(59 0) 568

6 (84 5%) 4\]^ Z,477 (84 0%) 4\]^ H P,476 (83 8%) 4\]^."Z[, 474 (83 4%) '?Y# Z [,469 (82 5%) 4 \]^ H'?,468 (82 4%) 4\]^ ] \ L E,4\]^ FG ) 4\]^ < 4;, 67!$B- =, Z 0 = P 1/2 E1 1/3 E1! 0A <*5"4\]^ 4;,#<*4;!$$"4; % 50% [5] & 4\]^ ' H,!$* \, 0 4\]^ 5 <* -., ] 9 4;.( 4, ) 4 DXA [6 7] ` *', 4 ( *, * 4\]^ +" B (P>0 05), *,+Z7 80%, 4 DXA -.,4 ( *,% X 95% ; /!,Z` 90% DXA,501 '` 4 ( * (45 6%) (60 0%), DXA%$ ( 2/6 DXA), Z 44% * ( ' 67 4%) ] $ 4\]^ H ) 5, & ] $ %$ ( ' I %$ DXA) 4\]^ ] U 4\]^ 5 H -., 2 3 H : 4 4; [8],+ 4\]^ <*, &<. # H,!$ ;<* 8 X 4\]^,@ A4;!$V! ` 23 4\]^ H 1 4\]^ Z[ ] R, J c ( 9:) R;,T *!$ -. Y [9] 4\]^ H / * D J * D 4\ ]^ 7,# R J c 50% *, 4\ ]^ -.Z, ' 4\]^,R, ( * 4\]^a# 01, Z[2\ 4 ( * 4\]^H ' 4\]^ # 4. 5, ( *' ' X, & ( *. ] ' 4 *!$44 < *4; 8,+4 * 4\]^ 4 ; H 01 ' ( Sorbi [10] 5< '<b4 * 4 \]^ ] H ' = * 4\]^ ] H ',4 4> < 4\]^.? ],> E1 A a#'z 40 < 4\]^!$ &4\]^ H> #, * 4 \]^a# ' U B>

7 116 Z[ 5 C, 4 \]^ 4; _` Z 5, % &' 4 DE *, Z Z 4, &` *'4,#, 672\ &, Z[ 4\]^ %& * -., ' W< * 4\] ^!$ `0 Z[ \]^ *,'4\]^ H# $%& * ', 17 * 4\] ^!$_` ( ) *, " ) *_` 4\]^ H 5 ) M! [1]Noauthorslisted.NIH consensusdevelopmentpanelon osteoporosisprevention,diagnosis,andtherapy,march 7-29,2000:HighlightsoftheConference[J].South MedJ,2001,94: [2]'FGI 04\]^ H'JKLM. 0.4\]^ 'JKL[J].'@FG_`"/ 0,2009,3: [3]Eliot GibsonV,BogochER,JamalSA,etal.Practice paternsinthediagnosisandtreatmentofosteoporosisaf terafragilityfracture:asystematicreview[j].osteopo rosint,2004,15: [4]WangO,HuY,GongS,etal.Asurveyofoutcomes andmanagementofpatientspostfragilityfracturesinchi na.[j].osteoporosint,2015,26: [5]EismanJA,BogochER,DelR,etal.Makingthefirst fracturethelastfracture:asbmr taskforcereporton secondaryfractureprevention[j].jboneminerres, 2012,27: [6]'@ "04\]^ 4,J-. 0. < 4\ ]^ HFN (20111)[J].'@4\]^ 4,J-./0,2011,4:2 17. [7]BernabeiR,MartoneAM,OrtolaniE,etal.Screening, diagnosisandtreatmentofosteoporosis: abriefreview [J]. Clin Cases Miner Bone Metab, 2014, 11: [8]ReidIR.Short term andlong term efectsofosteoporosis therapies[j].natrevendocrinol,2015,11: [9]KG, H.4\]^H Z[R [J]. IJK,2012,9: [10]SorbiR,Aghamirsalim M.Osteoporoticfracturepro grammanagement:whoshouldbeincharge?acompar ativesurveyofknowledgeinorthopaedicsurgeonsand internists[j].orthoptraumatolsurgres,2013,99: ( LM : )

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