110 DOI:10 3969/j.isn.1674 2591 2016 02 002 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\]^ *, '? 30~35 11 6 568 *, '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!"#$:A : (WBYZ2011 873);! " (7121012) #$%&:1 100730,' " " " ( )* +,*-./0 ( 1 ;2 110004,' " 23 45 ;3 100050,67 " 2 89 4 ;4 310014:;, 4 ;5 100091, <=> 309 4 '?4 ;6 321200@, A BC>5 4 ;7 215128D;, D D;E' 4 ;8 750004, " ( ;9 751500E, F G H I E J K C 4 ;10 401320 L, L M N I 4 ; 11 110044, 4 O ;12 400010L,L " 2> 4 ;13 215004D;, D D; " 2> 4 ;14 430022A,@' " P " 2 4 ;15 430400A,Q A RSI 4 ;16 100005,)* +,*-./0 4 ;17 100035, TUV WXY ;18 100730,' " " " #$:,E mail:wang_ou2010@126.com
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 110044,China;12 DepartmentofOrthopaedics,TheSecondHospitalAfiliatedtoChongqingMedicalUniversity, Chongqing400010,China;13 DepartmentofOrthopaedics,TheSecondHospitalAfiliatedtoSuzhouUniversity,Suzhou 215004,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 100035, 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
112 4\]^ 5 4 4 234 567489 : 4; : -. [1], < 4;0=>?!$ * \,@A67 ' B-,=CD'E 1 FG H 'F GI 04\]^ H'JKLM.0 20091<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 11 6 20131 12 A 20141 5, 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
113, I 1 1 11 4\] ^, 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, 23456789 491 (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) )' :234589 4\]^ 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) 0 763 * D 213(83 2) 56(98 2) 50(90 9) 171(85 5) 490(86 3) 0 018 J 197(77 0) 54(94 7) 36(65 5) 153(76 5) 440(77 5) 0 002 220(85 9) 56(98 2) 42(76 4) 170(85 0) 488(85 9) 0 010 163(63 7) 54(94 7) 43(78 2) 168(84 0) 428(75 4) 0 000 SERM 161(62 9) 42(73 7) 32(58 2) 145(72 5) 380(66 9) 0 051 J 157(61 3) 47(82 5) 36(65 5) 148(74 0) 388(68 3) 0 003 c 163(63 7) 46(80 7) 32(58 2) 133(66 5) 374(65 8) 0 055 ' 184(71 9) 44(77 2) 30(54 5) 145(72 5) 403(71 0) 0 039 Y+ 256(45 1) 57(10 0) 55(9 8) 200(35 2) 568(100 0) SERM:
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) 193 56(14 9) 48(12 8) 67(17 9) 204(54 4) 375 4 57(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
115 480 (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!$B- * @7,!$ =, 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%), 5 0 1 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\]^ 4 566 <*, &<. # H,!$7 7 9 4;<* 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< 4700 4 '<b4 * 4 \]^ ] H ' = * 4\]^ ] H ',4 4> < 4\]^.? ],> #,& @ E1 A a#'z 40 < 4\]^!$ &4\]^ H> #, * 4 \]^a# ' U B>
116 Z[ 5 C, 4 \]^ 4; _` Z 5, % &' 4 DE *, Z Z 4, &` *'4,#, 672\ &, Z[ 4\]^ %& * -., ' W< * 4\] ^!$ `0 Z[ 7 17 4\]^ *,'4\]^ H# $%& * ', 17 * 4\] ^!$_` ( ) *, " ) *_` 4\]^ H 5 ) M! [1]Noauthorslisted.NIH consensusdevelopmentpanelon osteoporosisprevention,diagnosis,andtherapy,march 7-29,2000:HighlightsoftheConference[J].South MedJ,2001,94:569 573. [2]'FGI 04\]^ H'JKLM. 0.4\]^ 'JKL[J].'@FG_`"/ 0,2009,3:148 154. [3]Eliot GibsonV,BogochER,JamalSA,etal.Practice paternsinthediagnosisandtreatmentofosteoporosisaf terafragilityfracture:asystematicreview[j].osteopo rosint,2004,15:767 778. [4]WangO,HuY,GongS,etal.Asurveyofoutcomes andmanagementofpatientspostfragilityfracturesinchi na.[j].osteoporosint,2015,26:2631 2640. [5]EismanJA,BogochER,DelR,etal.Makingthefirst fracturethelastfracture:asbmr taskforcereporton secondaryfractureprevention[j].jboneminerres, 2012,27:2039 2046. [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: 201 207. [8]ReidIR.Short term andlong term efectsofosteoporosis therapies[j].natrevendocrinol,2015,11:418 428. [9]KG, H.4\]^H Z[R [J]. IJK,2012,9:33 40. [10]SorbiR,Aghamirsalim M.Osteoporoticfracturepro grammanagement:whoshouldbeincharge?acompar ativesurveyofknowledgeinorthopaedicsurgeonsand internists[j].orthoptraumatolsurgres,2013,99: 723 730. ( LM :2015 11 03)