目的 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者应用基于Caprini量表评估的干预模式联合充气加压泵（IPC）预防静脉血栓（VTE）的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象，经随机数表法分为对照组41例予以VTE常规干预，观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓（VTE）发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组（P＜0.05）。干预前，两组AECOPD患者凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体水平比较差异无统计学意义（P＞0.05）；干预后，两组患者TT、PT、APTT、D-二聚体水平均降低，观察组较低（P＜0.05）。干预前，两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义（P＞0.05）；干预后，两组患者平均流速、血流峰速均升高，观察组高于对照组（P＜0.05）；阻力指数均降低，观察组低于对照组（P＜0.05）。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率，改善凝血指标与股静脉血流速。

   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression（IPC）in preventing venous thromboembolism（VTE）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group（41 cases）and an observation group（41 cases）using a random number table．The control group received routine VTE prevention，while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care．The extremity conditions，occurrence of VTE，coagulation parameters，and femoral venous blood flow velocity were compared between the two groups．Results The rates of extremity swelling，extremity pain，and VTE incidence in the observation group were lower than those in the control group（P＜0.05）．Before the intervention，there were no statistically significant differences in thrombin time（TT），prothrombin time（PT），activated partial thromboplastin time（APTT），or D?dimer levels between the two groups（P＞0.05）．After the intervention，TT，PT，APTT，and D?dimer levels decreased in both groups，with lower values in the observation group（P＜0.05）．Before the intervention，there were no statistically significant differences in mean flow velocity，peak flow velocity，or resistance index between the two groups（P＞0.05）．After the intervention，mean flow velocity and peak flow velocity increased in both groups，with higher values in the observation group（P＜0.05），while the resistance index decreased，with a lower value in the observation group（P＜0.05）．Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling，extremity pain，and VTE incidence，and improve  coagulation parameters and femoral venous blood flow velocity．

       目的   评估ChatGPT 4与Llama 3微调模型在乳腺癌诊断中的应用效果，特别是在超声、钼靶及超声联合钼靶的非结构化报告和影像诊断方面。方法   回顾性收集了689例同时接受乳腺超声和钼靶检查的患者数据，比较两种模型在文本和图像模态下的诊断性能，并探讨乳腺密度对模型表现的影响。结果   在文本模态下，微调Llama 3表现优异，联合诊断准确率达91.7%，优于ChatGPT 4的71.7%。图像模态中两模型准确率均低于70%，但ChatGPT 4灵敏度较高（78.3%），Llama 3特异度突出（98.3%）。分组分析表明，在非致密型乳腺中钼靶表现更佳，而致密型乳腺中超声诊断更具优势。结论   大语言模型在医学图像处理和多模态整合方面仍需进一步优化，医学领域微调的大语言模型在处理非结构化临床文本方面具有潜力。

       Objective  To evaluate the application effectiveness of ChatGPT 4 and the fine-tuned Llama 3 model in breast cancer diagnosis，particularly in processing unstructured reports and diagnostic imaging of ultrasound，mammography，and their combined modalities．Methods  Retrospective data from 689 patients who underwent both breast ultrasound and mammography examinations were collected．The diagnostic performance of the two models was compared across text and image modalities，and the impact of breast density on model performance was explored．Results  In the text modality，the fine-tuned Llama 3 model performed excellently，achieving a combined diagnostic accuracy of 91.7%，outperforming 71.7% of ChatGPT 4．In the image modality，both models had accuracies below 70%，but ChatGPT 4 exhibited higher sensitivity（78.3%），while Llama 3 demonstrated outstanding specificity（98.3%）．Subgroup analysis indicated that mammography performed better in non-dense breasts，whereas ultrasound was more advantageous in dense breasts．Conclusions  The large language models  still  require further optimization in medical image processing and multimodal integration，but fine-tuned large language models in the medical field show potential in handling unstructured clinical texts．

       目的   探讨经颅多普勒超声（TCD）参数联合屏气指数在颈内动脉（ICA）狭窄或闭塞所致急性脑梗死的评估价值。方法   选择2022年1月—2024年12月，在广州市花都区人民医院连续入组发病72 h内ICA狭窄或闭塞所致的急性脑梗死患者。记录患者人口统计学资料、临床资料及TCD相关参数，包括搏动指数（PI）、阻力指数（ RI）、大脑中动脉平均血流速度（Vm）及屏气指数等。依据患者数字减影血管造影（DSA）结果分为侧支循环良好组及侧支循环不良组。比较两组人口统计学、临床资料及TCD相关参数，采用单因素分析、多因素Logistic回归分析及ROC曲线。结果   共纳入ICA狭窄或闭塞所致急性脑梗死共136例，其中侧支循环良好组46例，侧支循环不良组90例。单因素分析提示：侧支循环良好组与侧支循环不良组在PI［0.95（0.80，1.03）vs 1.01（0.88，1.13）］、RI［0.58（0.51，0.62）vs 0.60（0.54，0.65）］、Vm［57（44，65）vs 50.5（41，63）］及屏气指数［0.78（0.75，0.85）vs 0.72（0.59，0.79）］方面，差异具有统计学意义（P＜0.05）。多因素Logistic回归分析提示Vm（OR=1.029，95%CI：1.006~1.053，P=0.014）、屏气指数（OR=723.401，95%CI：14.524~3 6031.859，P＜0.001）是侧支循环不良的独立危险因素。屏气指数和Vm评估侧支循环情况的ROC曲线下面积（AUC）分别为0.713（95%CI：0.627~0.799）和0.605（0.505~0.705），两者的AUC值比较差异无统计学意义（P＞0.05）。结论   屏气指数和Vm可以评估ICA狭窄或闭塞所致急性脑梗死的侧支循环，屏气指数和Vm的评估效能相当。

       Objective  To explore the evaluation value of transcranial Doppler ultrasound（TCD）in acute cerebral infarction caused by internal carotid artery（ICA）stenosis or occlusion．Methods  From January 2022 to December 2024，patients with acute cerebral infarction caused by ICA stenosis or occlusion within 72 hours of onset were enrolled in our hospital．Patient’s demographic data，clinical data，and TCD related parameters，including pulsatility index（PI），resistance index（RI），average blood flow velocity（Vm）of the middle cerebral artery，and breath holding index（BHI）were recorded．According to the results of digital silhouette angiography（DSA），patients were divided into good collateral group and poor collateral group．Demographic，clinical data，and TCD related parameters were compared between two groups using univariate analysis，multivariate Logistic regression analysis and ROC curve．Results  A total of 136 cases of acute cerebral infarction caused by  ICA stenosis or occlusion were included，including 46 cases in the collateral good group and 90 cases in the collateral poor group．Univariate analysis showed that the good collateral group and the poor collateral group were different in PI（0.95［0.80，1.03］vs 1.01［0.88，1.13］），RI（0.58［0.51，0.62］vs 0.60［0.54，0.65］），Vm（57［44，65］vs 50.5［41，63］），BHI（0.78［0.75，0.85］ vs 0.72［0.59，0.79］）（P＜0.05）．Multivariate Logistic regression analysis showed that Vm（OR=1.029，95%CI：1.006-1.053，P=0.014）and BHI（OR=723.401，95%CI：14.524-36 031.859，P＜0.001）were independent risk factors for collateral circulation disorders．The area under the ROC curve（AUC）for predicting collateral circulation using BHI and Vm were 0.713（95%CI：0.627~0.799）and 0.605（0.505~0.705），respectively．There was no statistically significant difference in AUC values between the BHI and Vm．Conclusions  The BHI and Vm can predict the collateral circulation of acute cerebral infarction caused by ICA stenosis or occlusion，and their predictive power is comparable．

       目的   通过机器学习方法构建脓毒症谵妄患者30 d死亡的预测模型，并识别关键预测因子。方法   采用基于医疗信息集成重症监护数据库（Medical Information Mart for Intensive Care IV）的回顾性队列研究方法，boruta筛选重要特征，并通过决策树，K近邻，LightGBM，随机森林，支持向量机，XGBoost构建模型进行分析，通过ROC曲线下面积进行评估，利用F1分数、召回率、精确率、特异度、灵敏度和阳性预测值比较模型表现。结果  XGBoost模型在训练集和验证集中的ROC曲线下面积分别为0.906和0.762，表明该模型具有良好的预测能力，入院年龄、红细胞分布宽度和白细胞计数是最重要的预测因子。结论   基于机器学习的脓毒症谵妄患者预后预测模型展现出良好的预测效能，为临床早期干预提供了重要参考依据。

       Objective  To construct a  30-day mortality  prediction model for  patients with  sepsis-associated  delirium using machine learning methods and identify key predictive factors．Methods  A  retrospective cohort study was conducted based on the Medical Information Mart for Intensive Care IV database．Important features were selected using the Boruta algorithm，and models including Decision Tree，K-Nearest Neighbors，LightGBM，Random Forest，Support Vector Machine，and XGBoost were constructed and analyzed．Model performance was evaluated using the area under the reciver operater characteristic（ROC）curve（AUC），along with F1 score，recall，precision，specificity，sensitivity，and positive predictive value．Results  The XGBoost model demonstrated strong predictive performance，with AUC values of 0.906 in the training set and 0.762 in the test set．Key predictors identified included admission age，red blood cell distribution width，and white blood cell count．Conclusions  The machine learning-based prediction model for sepsis-associated delirium prognosis exhibits robust predictive efficacy，providing a valuable tool for early clinical intervention．

      目的   采用两样本孟德尔随机化以及Meta分析研究趋化因子C-X3-C基序配体1（CX3CL1）表达水平与系统性红斑狼疮（SLE）发病风险的因果关系。方法   获取CX3CL1表达水平与SLE的全基因组关联研究（GWAS）数据，将单核苷酸多态性（SNP）作为工具变量并选择敏感的SNPs进行分析。通过逆方差加权法（IVW）、加权中位数法（WM）、MR-Egger回归法进行两样本MR分析，以OR值评估CX3CL1表达水平与SLE之间的因果关系，并对结果进行异质性和多效性检验。最后利用R软件Meta包进行Meta分析。利用coloc包进行共定位分析。结果   纳入9个SLE作为结局变量，其中4个变量ebi-a-GCST90018917（OR=2.14，95%CI：1.50~3.06），ebi-a-GCST003156（OR=2.25，95%CI：1.00~5.06），ebi-a-GCST90014238（OR=3.02，95%CI：1.54~5.94），finn-b-SLE_NOS（OR=1.81，95%CI：1.01~3.22）表明CX3CL1表达水平与SLE之间存在因果关系。关于 OR 95% CI 的森林图显示 SLE 患者的CX3CL1表达水平显著高于健康人群（OR=1.87，95%CI：1.53~2.29，P＜0.001）。共定位分析结果提示CX3CL1表达水平和SLE表型之间有共享的遗传变异位点（rs170364）。结论  CX3CL1表达水平与SLE存在正向因果关系，CX3CL1表达水平的升高使得SLE的发病风险升高。

       Objective  To investigate the causal  relationship  between CX3CL1 levels and the  risk of  systemic lupus erythematosus（SLE）using two-sample Mendelian randomization and Meta-analysis methods．Methods  Genome-Wide Association Study（GWAS）data for CX3CL1 levels and SLE were obtained．Single nucleotide polymorphisms（SNPs）were used as instrumental variables，and sensitive SNPs were selected for analysis．Two-sample Mendelian  randomization was performed using the inverse variance weighted（IVW）method，weighted median（WM）method，and MR-Egger  regression to evaluate the causal relationship between CX3CL1 levels and SLE，with OR values assessing this relationship．Heterogeneity and pleiotropy tests were conducted on the results．Meta-analysis was performed using the Meta package in R software，and colocalization analysis was conducted using the coloc package．Results  Nine SLE outcomes were included as outcome variables，with four variables（ebi-a-GCST90018917［OR=2.14，95%CI：1.50-3.06］，ebi-a-GCST003156［OR=2.25，95%CI：1.00-5.06］，ebi-a-GCST90014238［OR=3.02，95%CI：1.54-5.94］，finn-b-SLE_NOS［OR=1.81，95%CI：1.01-3.22］）indicating a causal relationship between CX3CL1 expression levels and SLE．The forest plot for OR 95%CI showed that CX3CL1 expression levels in SLE patients were significantly higher than in healthy individuals（OR=1.87［95%CI：1.53-2.29］，P＜0.001）．Colocalization analysis suggested that there was shared genetic variation sites（rs170364）between CX3CL1 expression levels and SLE phenotype．Conclusions  There is a positive causal relationship between CX3CL1 expression levels and SLE，with increased CX3CL1 levels elevating the risk of developing SLE．

目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。

Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice．Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study．This led to the integration of a preliminary evaluation framework．Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project．Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals．This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023．Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application．Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%．Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process．Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors．This system holds considerable potential for widespread clinical adoption and application．

目的 探讨64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。方法 选择2023年7月—2024年5月在潜江市中心医院诊治的主动脉夹层疑似患者96例为研究对象,所有患者均进行64层螺旋CT三维重建技术检查, 记录成像参数。所有患者在64层螺旋CT三维重建后进行介入治疗, 以介入检查结果为金标准, 判断64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。结果 在96例患者中, 64层螺旋CT三维重建联合判断为主动脉夹层60例, 其中Ⅰ型32例、Ⅱ型20例、Ⅲ型8例,其中再现（VR）、最大密度投影（MIP）及多平面重建（MPR）分别判断为主动脉夹层56例、54例、56例。在96例患者中, 64层螺旋CT三维重建检查的破口层面主动脉平均直径（3.08±0.25）cm、破口至左锁骨下平均距离（4.05±0.26）cm, 与介入治疗检查（3.05±0.36）cm、（4.06±0.14）cm, 对比差异无统计学意义（t=0.671, P=0.503; t=0.332, P=0.740）。64层螺旋CT三维重建联合、VR、MIP、MPR对主动脉夹层的诊断灵敏度分别为98.33%、93.22%、89.83%、94.92%, 特异度分别为97.30%、97.30%、97.30%、100.00%, 准确率分别为98.96%、94.79%、92.71%、96.88%。结论 64层螺旋CT三维重建技术在主动脉夹层介入术前评估中具有很高的灵敏度、特异度与准确率。

Objective To explore and analyze the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection（AD）intervention．Methods From July 2023 to May 2024, 96 cases of patients suspected of aortic dissection treated in our hospital were selected as the research subjects．All patients underwent 64-slice spiral CT three-dimensional reconstruction technology examination, and imaging parameters were recorded．After the 64-slice spiral CT three-dimensional reconstruction, all patients were given interventional treatment, and the results of the interventional examination were used as the “gold standard” to evaluate the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection intervention．Results Among the 96 patients,64-slice spiral CT three-dimensional reconstruction combined diagnosis identified 60 cases of aortic dissection,including 32 type I, 20 type II, and 8 type III cases．volume rendering（VR）, maximum intensity projection（MIP）, and muhiplanar reconstrudion（MPR） identified 56, 54, and 56 cases of aortic dissection,respectively．In 96 patients, the mean aortic diameter at the lacerated level and the mean distance from the lacerated to the left subclavicular level were（3.08±0.25）cm and（4.05±0.26）cm respectively in 64-slice spiral CT three-dimensional reconstruction examination, compared with（3.05±0.36）cm and（4.06±0.14）cm in interventional examination．There was no difference in comparison（t=0.671, P=0.503; t=0.332, P=0.740）．The sensitivity, specificity, and accuracy of the 64-slice spiral CT three-dimensional reconstruction combined, VR, MIP, and MPR for the diagnosis of aortic dissection were 98.33%, 93.22%, 89.83%, 94.92%, specificity were 97.30%, 97.30%, 97.30%, 100%, accuracy were 98.96%, 94.79%, 92.71%, 96.88%．Conclusions Technology of 64-slice spiral CT three-dimensional reconstruction has high sensitivity, specificity, and accuracy in the preoperative assessment of aortic dissection intervention and is worth promoting and applying clinically．

目的 探讨盆底磁刺激联合生物反馈治疗女性膀胱过度活动症的疗效。方法 选择2022年8月—2023年7月福建医科大学附属福州市第一医院妇科接收的女性膀胱过度活动症患者90例为研究对象,以随机数字表法分为两组,每组各45例,对照组采取常规药物及康复治疗,观察组在此基础上给予盆底磁刺激联合生物反馈治疗,比较两组治疗效果、排尿功能、尿流动力学及生活质量。结果 观察组治疗有效率43例（95.56%）高于对照组36例（80.00%）（χ²=5.074,P=0.024）。治疗后观察组白天排尿次数（7.22±2.25）次、夜间排尿次数（2.05±0.44）次、尿急（1.54±0.48）次、急迫性尿失禁（1.22±0.25）次,低于对照组相应的（10.01±2.84）（3.32±0.84）（2.52±0.92）（2.24±0.39）次（t=5.165、8.984、6.335、14.770,P<0.05）。治疗后观察组初始尿意膀胱容量（188.45±24.43）mL、最大膀胱测压容积（320.42±25.49）mL,高于对照组的（155.54±20.06）（272.26±21.16）mL,膀胱顺应性（40.15±4.06）mL/cmH₂O、残余尿量（82.25±8.45）mL,低于对照组的（50.05±5.54）mL/cmH₂O、（125.44±12.26）mL（t=6.983、9.751、9.669、19.457,P<0.05）。治疗后观察组I-QOL（72.25±7.46）分,高于对照组（63.63±6.05）分（t=6.020,P<0.05）。结论 针对女性膀胱过度活动症患者采取盆底磁刺激联合生物反馈治疗可取得良好的治疗效果,减少患者排尿次数和残余尿量,改善尿急、尿失禁症状,恢复正常的尿流动力学,提高生活质量。

目的 探讨血清胱抑素C（SCys-C）、同型半胱氨酸（Hcy）及尿微量白蛋白（UmAlb）在高血压患者肾损害早期评估中的应用价值。方法 选择2022年9月—2023年9月期间福建中医药大学附属第三人民医院接收的150例高血压患者作为观察组,另选择健康体检者150例为对照组,测定肾小球滤过率（GFR）、SCys-C、Hcy、UmAlb,比较不同血压程度及对照组的各指标水平,比较观察组各指标检测阳性率及诊断符合率,依据GFR值评估肾损害程度,比较不同肾损害程度患者的SCys-C、Hcy、UmAlb水平。结果 高血压2级、高血压3级患者SCys-C、Hcy、UmAlb水平高于高血压1级患者（t=5.255、10.976、21.578,P<0.05;t=7.378、18.012、23.708,P<0.05）及对照组患者（t=8.308、19.675、31.891,P<0.05;t=10.661、31.511、21.578,P<0.05）,高血压3级患者高于高血压2级患者（t=2.776、12.725、7.779,P<0.05）。观察组肾损害患者SCys-C、Hcy、UmAlb的阳性率79.41%、73.53%、83.82%高于无肾损害患者的阳性率6.10%、4.88%、6.10%（χ²=83.733、76.040、92.613,P<0.05）。观察组中重度肾损害、轻度肾损害患者的SCys-C、Hcy、UmAlb水平高于无损害患者（t=7.567、24.214、30.836,P<0.05;t=5.783、16.054、25.164,P<0.05）,中重度肾损害高于轻度肾损害患者（t=2.685、7.179、9.561,P<0.05）。结论 高血压分级越高患者的SCys-C、Hcy、UmAlb水平越高,各指标联合检测的阳性率高,而且SCys-C、Hcy、UmAlb水平越高,肾损害程度越严重。

Objective To explore the application value of serum cystatin C（SCys-C）,homocysteine（Hcy） and urinary microalbumin（UmAlb）in early assessment of renal damage in hypertensive patients．Methods A total of 150 hypertensive patients admitted to the Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the observation group,and 150 healthy individuals were selected as the control group．Glomerular filtration rate（GFR）,serum cystatin C（SCys-C）,homocysteine（Hcy）,and UmAlb were measured,and the levels of various indicators in different blood pressure levels and the control group were compared．The positive rate and diagnostic accuracy of each indicator in the observation group were compared,and the degree of renal damage was evaluated based on GFR values．The levels of SCys-C,Hcy and UmAlb in patients with different degrees of renal damage were compared．Results The levels of SCys-C,Hcy and UmAlb in patients with grade 2 and grade 3 hypertension were significantly higher than those in patients with grade 1 hypertension（t=5.255,10.976,21.578,P<0.05;t=7.378,18.012,23.708,P<0.05）,as well as in the control group（t=8.308,19.675,31.891,P<0.05;t=10.661,31.511,21.578,P<0.05）,patients with grade 3 hypertension were significantly higher than those with grade 2 hypertension（t=2.776,12.725,7.779,P<0.05）．The positive rates of SCys-C,Hcy and UmAlb in patients with renal injury in the observation group were 79.41%,73.53% and 83.82%,which were significantly higher than the positive rates of 6.10%,4.88% and 6.10% in patients without renal injury（χ²=83.733,76.040,92.613,P<0.05）．The levels of SCys-C,Hcy and UmAlb in patients with severe and mild kidney damage in the observation group were significantly higher than those in patients without damage（t=7.567,24.214,30.836,P<0.05;t=5.783,16.054,25.164,P<0.05）,patients with moderate to severe kidney damage were significantly higher than those with mild kidney damage（t=2.685,7.179,9.561,P<0.05）．Conclusions The higher the grading of hypertension,the higher the levels of SCys-C,Hcy and UmAlb in patients,and the higher the positive rate of combined detection of various indicators．Moreover,the higher the levels of SCys-C,Hcy and UmAlb,the more severe the renal damage．

目的 应用FRAX^®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX^®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX^®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX^®工具进行骨折风险评估。

Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.