武川县农村居民膝关节骨关节炎患病率调查

The high prevalence of knee osteoarthritis in a rural Wuchuan population

目的评估内蒙古武川县居民膝关节骨关节炎的患病率，并与北京及弗雷明汉（美国马萨诸塞州）地区研究数据进行比较。方法利用扩大免疫规划整体抽样的方法，抽取内蒙古武川县当地50岁及以上居民1025名，大多数为重体力劳动者。受调查者在完成统一的骨关节炎问卷后接受双膝负重半屈曲后前位X线检查。结果武川县居民有影像学表现的膝关节骨关节炎患病率与北京居民接近。武川县男性居民有重度影像学表现与有疼痛症状的膝关节骨关节炎患病率均高于北京居民，患病率比率分别为2．48和1．91，95％C1分别为（1．62，3．78）和（1125，2．91）；武川县女性居民有重度影像学表现与有疼痛症状的膝关节骨关节炎患病率也高于北京居民，患病率比率分别为1．42和1．55，95％凹分别为（1．03，1．97）和（1．17，2．05）。在武川研究和北京研究中，双侧骨关节炎和单问室骨关节炎的患病率均为弗雷明汉研究中相关结果的2-3倍。结论武川县农村人口中有疼痛症状的膝关节骨关节炎的患病率高于北京城市人口及弗雷明汉地区居民。武川地区和北京地区双侧及单间室骨关节炎的高患病率是其独特的骨关节炎表型。这一结果将有助于未来医疗资源的分配和疾病的预防工作。

Objective To estimate the prevalence of radiographic and symptomatic knee osteoarthritis （OA） in a remote rural region of northern Chiua （Wuchuan County, Inner Mongolia ） and compare these with those reported in Beijing and data from the Framingham （Massachusetts, USA） cohort. Methods A population-based cross sectional survey was conducted among 1025 residents of Wuchuan County, Inner Mongolia, aged 50 years and over. Survey participants, mostly farmers reporting heavy physical occupational activity, completed an interviewer based questionnaire and obtained bilateral weightbearing posterior-anterior semi-flexed knee radiographs. Results While the prevalence of radiographic knee OA was similar to that demonstrated in the Beijing OA study, the prevalence of severe radiographic [prevalence ratio （PR） 2.48, 95%CI（ 1.62, 3.78）] and symptomatic knee OA [PR 1.91, 95%CI（1.25, 2.91）] in men in Wuchuan were higher than ones in Beijing. Women in Wuchuan also had a higher prevalence of both severe radiographic [PR 1.42, 95%CI （1.03, 1.97）] and symptomatic knee OA [PR 1.55, 95%CI（1.17, 2.05）] compared with their Beijing counterparts. The prevalence of bilateral OA and lateral compartment OA were two to three times higher in both Chinese cohorts compared with estimates from the Framingham OA Study. Conclusion The prevalence of symptomatic knee OA in rural areas of Wnchuan is much higher than that reported from urban regions of China （Beijing） or in the Framingham cohort. The higher representation of bilateral and lateral compartment OA in China suggests a unique phenotype to OA. The findings will be useful to guide the distribution of future health care resources and preventive strategies.