慢性乙型肝炎肝病患者骨质疏松性椎体压缩骨折的调查研究

Epidemiologic study of osteoporotic vertebral compression fractures in patients with chronic hepatitis B

目的调查慢性乙型肝炎患者骨质疏松性椎体压缩骨折的发生率,并与正常人群作对比研究。方法随机选取300例慢性乙型肝炎患者为实验组,选取年龄、性别、身高、体重相匹配的100例健康志愿者作为对照组,进行胸腰椎X线片检查诊断脊椎压缩骨折,测定跟骨骨密度,对相关数据进行相应的统计学分析。结果慢乙肝组的跟骨SI与对照组SI比较有显著统计学差异(P<0.05)。肝硬化A组、B组、C组患者SI值明显低于对照组SI。肝硬化A组、B组、C组)SI有明显降低趋势。慢性乙型肝炎患者共有30例(10%)发生椎体压缩骨折,正常对照组3例(3%)发生椎体压缩骨折,差异显著有统计学意义(P<0.01)。结论慢性乙型肝炎患者组硬度指数较正常对照组明显减低。数据说明慢性乙肝肝硬化的患者更容易出现骨质疏松性椎体压缩骨折,骨质疏松性椎体压缩骨折患病率随着肝硬化的严重程度逐渐升高。

Objective To investigate the incidence rate of osteoporotic vertebral compression fractures in patients with chronic hepatitis B and compared with that in normal healthy people. Methods 300 patients with chronic hepatitis B were randomly selected as experimental group. 100 healthy people matched by age,sex,height and body weight were selected as control group. The os- teoporotic vertebral compression fractures in patients were diagnosed by X ray. The value of stiff- ness index （SI） of calcaneus was measured. The data were statistically analyzed. Results The SI of control group （98.73_＋13.19） was significantly higher than that of experimental group （83.99_＋11. 86）（P〈0.05）. The SI of caleaneus in cirrhosis patients with Child-Pugh class A,B,C was signifi- cantly lower than that in control group. Tile SI of cirrhosis gradually reduced from Child-Pugh class A to class C. 30 cases occurred osteoporotic vertebral compression fractures in patients with chronic hepatitis B,while 3 cases occurred osteoporotic vertebral compression fractures in control group. There was significant difference between the two groups （P〈0.01）. Conclusion The SI of healthy people was significantly higher than patients with chronic hepatitis B. The results showed that chronic hepatitis B patients were easily occurred osteoporotic vertebral compression fractures. The incidence rate of osteoporotic vertebral compression fractures gradually increased with the severity of cirrhosis.