摘要
目的探讨中老年妇女跌倒相关疾病和髋部骨折的关系。方法研究对象为日本长崎县国民健康保险的参保者。收集45岁以上妇女髋部骨折住院患者1109例,按年龄配比随机抽取1109名其他患者,进行病例对照研究。髋部骨折和跌到相关疾病根据国际疾病分类标准编码第十版(ICD-10)进行判定。卡方检验用于比较两组患者跌倒相关疾病的患病率差,条件Logistic回帰分析用于分析跌倒相关疾病与髋部骨折的关联性。结果 75%以上的髋部骨折患者的年龄大于80岁。髋部骨折患者的视力障碍(14.25%vs.8.66%,P<0.001),脑卒中(14.07%vs.9.92%,P=0.002),肌肉骨骼疾病(43.91%vs.38.77%,P<0.001),帕金森氏病(5.86%vs.1.53%,P<0.001),认知障碍(11.45%vs.4.33%,P<0.001)和抑郁症(13.89%vs.5.86%,P<0.001)的患病率显著高于对照组。这些疾病的髋部骨折相对危险度分别为:视力障碍1.49(95%CI:1.13,1.98)、脑卒中1.29(95%CI:0.98,1.69)、肌肉骨骼疾病1.29(95%CI:1.08,1.54)、帕金森氏病3.33(95%CI:1.87,5.92)、认知障碍2.46(95%CI:1.72,3.52)和抑郁症2.09(95%CI:1.54,2.85)。合并的跌倒相关疾病越多,髋部骨折风险越大。结论在中老年妇女,跌倒相关疾病与髋部骨折有显著的关联性。积极预防和治疗跌倒相关疾病可能有益于降低髋部骨折的发生危险。
Objective To study the correlation between fall-related diseases and hip fracture among the elderly women. Methods A total of 1109 women, who were over 45 years old and had hip fractures, were identified from health insurance claims in Nagasaki Prefecture in Japan. At the same time, a age-matched （within 5-year age groups） control patient was randomly selected for each patient with hip fracture. Diseases such as hip fracture and the fall-related diseases were coded following the International Classification of Diseases, 10th Revision （ICD-10）. The prevalence of visual impairment, stroke, musculosketetal diseases, Parkinson＇ s disease, cognitive impairment, depression, and the number of these risk factors were compared between patients with hip fractures and controls using the Chi-square test. The strength of the association between risk factors and hip fracture was estimated using a conditional Logistic regression model. Results Over 75% women with hip fracture were over 80 years old. Women with hip fracture had a significantly higher prevalence of ocular diseases （ 14. 25% vs. 8.66% , P 〈 0. 001 ）, stroke （ 14.07% vs. 9. 92% , P =0. 002） , musculoskeletal diseases （43.91% vs. 38.77% , P 〈 0. 001 ）, Parkinson＇ s disease （5.86% vs. 1.53%, P〈0.001）, cognitive impairment （11.45% vs. 4.33%, P〈0.001）, and depression （13.89% vs. 5.86%, P〈0. 001 ） than those in controls. The results of conditional Logistic regression showed that ocular diseases （ OR = 1.49, 95% CI ： 1. 13, 1.98）, stroke （OR = 1.29, 95% CI： 0.98, 1.69）, musculoskeletal diseases （ OR = 1.29, 95% CI： 1.08, 1.54）, Parkinson＇ s disease （OR =3.33, 95% CI： 1.87, 5.92）, cognitive impairment （OR = 2.46, 95% CI： 1.72, 3.52）, and depression （OR = 2.09, 95% CI： 1.54, 2.85 ） were significantly associated with hip fracture. Women with multiple risk factors were at higher risk of the hip fractures. Conclusion Fall-related diseases play an important role in hip fracture among the middle-aged and elderly women. Positive prevention and treatment of the fall-related diseases may contribute to lower the risks of hip fracture.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2014年第7期839-843,共5页
Chinese Journal of Osteoporosis
