股骨头坏死的病因构成及发病特征分析

Etiological Composition and Characteristics of Osteonecrosis of Femoral Head

目的探讨股骨头坏死的病因构成及发病特征,为股骨头坏死的防治提供理论依据。方法采用现场调查问卷的方式,对188例(271髋)股骨头坏死患者的发病诱因、发病年龄、性别、职业、病程等,进行调查研究。运用频数、构成比的方法统计分析。按病因分组,分析不同性别、不同年龄段、发生侧别的病因构成比;从发病年龄、分期、职业方面分析发病特征。结果病因构成比激素性占36.17%,酒精性占28.72%、创伤性占20.21%、病因不明性占14.90%;男女之比2.62:1;14～20岁、68～82岁,创伤性约占2/3;20～36岁,激素性所占比例超过1/2;36～52岁,酒精性、激素性各占2/5左右;52～68岁,酒精性、激素性、创伤性、病因不明性四者各约占1/4;单双侧患者之比为1.26:1。发病年龄主要集中在20～52岁之间;男性发病时间比女性早。疾病分期,以Ⅱ期所占比例最高,接近60%。农民、工人、干部,所占的比例分别是22.40%、17.53%、14.94%。结论激素已经成为股骨头坏死的主要原因。发病年龄以青壮年为多。男性发病高于女性,男性发病比女性早,男性酒精性比例最高、女性激素性比例最高。激素性多双侧发病,创伤性多为单侧。疾病分期以Ⅱ期所占比例最大。患者中农民所占比例最大。

Objective To investigate the etiological composition and characteristics of osteonecrosis of the femoral head （ONFH） for providing the theoretical evidence for the prevention and treatment of ONFH. Methods The data and information of etiology, age, gender, occupation, and disease course of ONFH were collected with on-the-spot investigation. The method of frequency and constituent ratio was used for statistic analysis. The etiologic composition of ONFH was analyzed according to age and gender, and the characteristics of ONFH from the aspects of age, occupation and disease stage were analyzed. Results The proportion of alcoholic, steroid-induced, traumatic ONFH and the others was respectively 36.17% ,28.72% ,20.21% ,and 14.90%. The ratio of male to female was 2.62：1.The proportion of traumatic ONFH aged 14-20 and 68-82 was about 2/3, steroid-induced ONFH aged 20-36 over 1/2, alcoholic and steroid-induced ONFH aged 36-52 respectively 2/5 or so, and alcoholic, steroid-induced, traumatic ONFH patients, and the others aged 52-68 respectively 1/4. The onset time of male was earlier than that of female. The proportion of patients at stage II was 60%. The proportion of patients who were peasants, workers, and leaders by profession was respectively 22.40%, 17.53% and 14.94%. Conclusion Steroid has become the main etiology of ONFH. The patients are mainly young persons. The incidence of male is higher than female, and the onset time of male is also earlier than that of female. The proportion of male with alcoholic ONFH is higher than that of female while the proportion of female with steroid-induced ONFH is higher than that of male. Steroid-induced ONFH always incurred in bilateral femoral heads, and traumatic ONFH always in unilateral femoral head .The proportion of patients at stage Ⅱ or peasants by profession is the highest.