中老年妇女203例原发性骨质疏松症与骨关节病患病情况分析

Prevalence of primary osteoporosis and osteoarthrosis in 203 middle-aged and elderly women

目的:统计骨质疏松症、膝关节骨关节炎和腰椎骨质增生的发病情况,并分析骨质疏松症和骨关节病间的相互影响及相互关系。方法:①选择2002-06/2003-09哈尔滨医科大学附属第二医院老年病门诊就诊,以严重腰背痛,腰腿痛,下肢无力,行走费力为主诉的中老年妇女203例。均对检测项目知情同意。②应用双能量X线骨密度仪,测定第2～4腰椎正位椎体骨密度,应用数字减影X光机拍摄腰椎正侧位X线片,单或双膝关节正侧位X线片,进行诊断和分析。③骨质疏松症的诊断标准:骨量减少>25%(T值<-2.0SD以上)。骨关节病的诊断标准:膝关节骨关节炎:X线片显示膝关节关节间隙狭窄,或关节内骨刺或关节腔内表面凸凹不平或关节内骨硬化;腰椎骨质增生:X线片显示2个锥体以上前缘或/和后缘增生、骨赘形成或骨桥形成。以10岁为一个年龄组进行情况分析。结果:纳入中老年妇女203例均进入结果分析。①203例中老年妇女中原发性骨质疏松症和膝关节骨关节炎及腰椎骨质增生患病率:50～59岁34.0%,39.6%,35.8%;60～69岁44.8%,52.9%,48.3%;70～79岁为58.8%,68.6%,58.8%;80～89岁为66.7%,75.0%,83.3%。②在诊断骨质疏松症的95例中T值<-2.5SD者20例,23个锥体出现骨质疏松性压缩性骨折,只有2例同时有2个腰椎压缩性骨折。③有67例(34%)同时患膝关节骨关节炎和腰椎骨质疏松症。结论:①中老年妇女原发性骨质疏松症和骨关节病均随增龄而升高。②腰椎骨质增生可影响腰椎骨量,致骨量增高,使腰椎骨质疏松性骨折数量减少。③部分中老年妇女可同时患骨质疏松症和老年骨关节病。

AIM： To investigate the occurrence of primary osteoporosis, knee os- teoarthrosis and lumbar hyperostosis, and explore the interaction and correlation between osteoporosis and osteoarthrosis. METHODS： ①Totally 203 middle-aged and elderly women were collected from the outpatients of Department of Geriatrics, the Second Affiliated Hospital of Harbin Medical University from June 2002 to September 2003. Their main symptoms focused on severe low back pain, asthenia of lower limbs and hard walking. They all participated in the study voluntarily. ② Bone mineral density （BMD） of 2-4 lumbar normotopia centrum were measured with dual-energy X-ray absorptiometry （DEXA）, X-ray scotographs of obverse and profile lumbar, single or double knee joint were shot with digital silhouette X-ray apparatus, and then diagnosis was got and data were analyzed. ③ Diagnostic criteria of osteoporosis： osteopenia 〉 25% （T score〈 -2.0 SD）; Diagnostic criteria of osteoarthrosis： knee osteoarthrosis： joint space stenosis, spur, rough and uneven in surface, bone sclerosis-showed by X-ray. lumbar hyperostosis： more than 2 centrum exterior edge and posterior edge hyperplasia, osteophyma, bone bridge showed by X-ray. Ten years old was taken as an age group for analysis. RESULTS： All the 203 middle-aged and elderly women entered the anal- ysis of results. ① The prevalence rates of osteoporosis, knee osteoarthrosis and lumbar hyperostosis in the 50-59 years old were 34.0%, 39.6%, 35.8%, in the 60-69 years old group were 44.8%, 52.9%, 48.3%, in the 70-79 years old group were 58.8%, 68.6%, 58.8%, in the 80-89 years old were 66.7%, 75.0%, 83.3%. ② Of the 95 cases for the diagnosis of osteoporosis, T value was 〈 -2.5 SD in 20 eases, osteoporotic and compressive fractures occurred in 23 cones, only 2 cases had two compressive fractures at the same time. ③ Sixty-seven patients （34%） developed lumbar hyperostosis and knee osteoarthrosis at the same time. CONCLUSION： ①The incidence rates of primary osteoporosis and osteoarthrosis in middle-aged and elderly women increase with aging. ② Lumbar hyperostosis can increase lumbar bone mass, and reduce lumbar vertebra osteoporotic fracture; ③ Part of the middle-aged and elderly women develop osteoporosis and osteoarthrosis at the same time.