应用倾向性评分分析男性跟腱断裂的危险因素

Risk factors analysis of achilles tendon rupture in male by propensity score

目的应用倾向性评分方法探讨男性跟腱断裂的危险因素并进行验证。方法回顾性分析2013年5月至2020年6月山东大学齐鲁医院收治的男性住院跟腱断裂患者(跟腱断裂组,242例)和单纯踝关节损伤患者(对照组,825例)的病例资料,以1∶1比例使用倾向性评分匹配方法均衡混杂因素,匹配后跟腱断裂组147例,对照组147例。匹配前后对基线资料及相关指标进行比较,通过构建多因素logistic回归模型分析跟腱断裂发生的危险因素。结果匹配前跟腱断裂组年龄、吸烟比例、饮酒比例,高血压、糖尿病家族史比例,既往高血压、糖尿病、冠心病病史比例,BMI明显小于对照组,差异有统计学意义(均P<0.05)。匹配后两组年龄、吸烟比例、饮酒比例,高血压、糖尿病、冠心病家族史比例,既往高血压、糖尿病、冠心病病史比例,BMI比较差异无统计学意义(均P>0.05)。匹配后跟腱断裂组空腹尿酸(UA)、胆固醇(TG)、甘油三酯(TC)水平明显高于对照组,差异有统计学意义(均P<0.05)。多因素二元logistic回归分析显示UA(OR=1.006,95%CI:1.003~1.010,P<0.001)、TC(OR=2.462,95%CI:1.194~5.076,P=0.015)是男性跟腱断裂发生的独立危险因素。结论血脂异常、尿酸可能是男性跟腱断裂的独立危险因素。

Objective To investigate the risk factors of achilles tendon rupture in male patients and to verify them.Methods Retrospective analysis was made on the medical records of male inpatients with achilles tendon rupture(242 cases in achilles tendon rupture group)and simple ankle joint injury(825 cases in control group)admitted to Qilu Hospital of Shandong University from May 2013 to June 2020.The tendency score matching method was used to balance the confounding factors at a ratio of 1∶1.After matching,147 cases were in achilles tendon rupture group and 147 cases in control group.The baseline data and related indicators were compared before and after matching,and the risk factors of achilles tendon rupture were analyzed by constructing a multivariate logistic regression model.Results The age,smoking rate,drinking rate,family history of hypertension and diabetes,previous history of hypertension,diabetes and coronary heart disease,and BMI of the achilles tendon rupture group before matching were significantly lower than those of the control group(all P<0.05).After matching,there was no significant difference in age,smoking proportion,drinking proportion,family history of hypertension,diabetes and coronary heart disease,previous history of hypertension,diabetes and coronary heart disease,and BMI between the two groups(all P>0.05).After matching,the levels of fasting uric acid(UA),cholesterol(TG)and triglyceride(TC)in achilles tendon rupture group were significantly higher than those in control group,and the differences were statistically significant(all P<0.05).Multivariate binary logistic regression analysis showed UA(OR=1.006,95%CI:1.003-1.010,P<0.001),TC(OR=2.462,95%CI:1.194-5.076,P=0.015)was an independent risk factor for achilles tendon rupture in male.Conclusions Dyslipidemia and UA may be an independent risk factor for achilles tendon rupture in male.