中国6城市中老年人群X射线颈椎骨关节炎流行病学分析

Epidemiology of cervical osteoarthritis in middle-aged and elderly population in six cities of China

目的:颈椎骨关节炎是使颈椎关节发生障碍的疾病,严重影响中老年人群的生活质量。采用X射线检查中国6个城市中老年人群颈椎骨关节炎患病情况,为了解颈椎骨关节炎的病因和防治研究提供科学依据。方法:调查于2005-06/08在西安、石家庄、上海、广州、哈尔滨、成都六大城市完成。①调查对象为年龄≥40岁,具有常住户口男女汉族人群4785人,其中男2162人,平均年龄54.87岁;女2623人,平均年龄54.78岁。男女性别比为0.82∶1.00。②调查方法:采用分层多阶段整群随机抽样方法对调查对象人群进行问卷调查:包括一般情况、现病史、既往史、体格检查、X射线平片检查情况、疾病诊断;颈椎X射线正侧位投照:判断标准为颈椎关节至少有1个关节Kellgren&Lawrence分级≥2级,3级,4级判定为重度骨关节炎。结果:中国6个城市中老年人群X射线平片检测颈椎骨关节炎总患病率48.5%,其中男49.5%,女47.7%,男女之间比较差异无意义(P>0.05);各城市间比较,差异有显著性意义(P<0.01),广州(81.4%)>上海(76.6%)>哈尔滨(50.9%)>成都(44.1%)>西安(32.2%)>石家庄(20.3%)。颈椎骨关节炎患病率随年龄增长而升高(P<0.01);城乡比较差异无显著性意义(P>0.05)。结论:中国6个地区中老年男女人群X射线平片检测颈椎骨关节炎患病率均较高,地区、年龄、城乡分布有显著差异。

AIM： Cervical osteoarthritis is a kind of disease that seriously affects cervical joint function and life quality of the elderly population In this study, distribution of prevalence of cervical spine osteoarthritis in six cities of China was measured by X-ray, and to provide a scientific basis for the prevention and treatment of cervical osteoarthritis. METHODS： The survey was performed in six cities including Xi＇an, Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu from June to August in 2005. （1）4 785 Han people aged above 40 years including 2 162 males with mean aged 54.87 years and 2 623 females with average aged 54.78 years were selected. The ratio of male to female was 0.82 to 1.00. （2）Using stratified-multi-step-cluster sampling method, questionnaire was surveyed. The contents of questionnaire were as follows： general information, history and current diseases, physical examination, X-ray film and diagnosis. In addition, the right and side cervical spine was examined by X-ray and diagnosed according to Kellgren ＆ Lawrence classification （more than 1 hand joint ≥ grade 2; Grades 3 and 4 were considered as severe osteoarthritis）. RESULTS： The X-ray film showed that total prevalence rate of cervical osteoarthritis in six cities of China was 48.5%. The prevalence rate of males was 49.5% and that of females was 47.7% （P 〉 0.05）. There were significant differences in the prevalence of cervical osteoarthritis among six cities （P 〈 0.01）, which was most in Guangzhou （81.4%） and least in Shijiazhuang （20.3%）. The prevalence rate of cervical spine osteoarthritis was increased with age （P 〈 0.01 ）. There were significant differences in the prevalence of cervical osteoarthritis between urban and rural areas （P 〈 0.01）. CONCLUSION： The prevalence of cervical osteoarthritis by X-ray is very common both in the middle-aged and elderly population in six cities of China. The distributions of the prevalence of cervical spine osteoarthritis are significantly different among different sexes, cities and areas.