老年髋部骨折风险与Singh指数相关性研究

Correlation between senile hip fracture risk and Singh index

目的探讨应用Singh指数预测老年人骨质疏松性骨折,并为发现高危人群提供简便廉效的方法。方法本文统计了888例因受轻微外伤致股骨颈或粗隆间骨折患者的情况,拍骨盆正位片并用Singh六级分类法统计股骨上端骨小梁级数,并对骨折进行分型;运用SPSS软件探索不同性别、髋部不同骨折部位之间Singh指数分级差异;年龄、骨折分型与Singh指数的等级相关性等。结果男性平均级数4.11±1.52,女性平均级数为3.08±1.40;股骨颈骨折患者为3.60±1.54,而粗隆间骨折的平均级数为3.12±1.43;两组数据经独立样本t检验均示P=0.000,具有非常显著的差异。Spearman等级相关分析显示:年龄与Singh指数具有非常显著地正相关性;而骨折分型方法中只有股骨颈骨折Garden分型与指数具有一定程度的负相关性。结论 Singh指数可作为有效的骨质疏松性髋部骨折风险评估的方法,尤其是对女性股骨颈骨折具有较大的预示意义;骨质疏松症是老年人髋部骨折的高危因素,其判断标准是股骨上端骨小梁级数下降男性低至Ⅳ级,女性低至Ⅲ级。

Objective To explore the application of Singh index （SI） for preventing and monitoring osteoporotic fracture risk in the elderly, and to provide simple, inexpensive, and efficient method for identifing high risk groups. Methods Eight hundred and eighty-eight patients with femoral neck or intertrochanterie fractures due to minor trauma were recruited. Digital anterior-posterior pelvic radiographs were obtained for assessment of SI and fracture types. We applied SPSS software to explore the statistical differences of SI among different genders, different parts of fractures, age, and fracture types and Singh. Results The average grade of SI in males was 4.11 _＋ 1. 519, while 3.08 ~ 1. 398 in females. It was3. 60 ＋ 1.54 in patients with femoral neck fractures and 3.12 ~ 1.43 in those with intertrochanteric fractures. Independent sample t test showed that significant differences existed between the 2 groups （P = 0. 000）. Spearman rank correlation analysis showed that significant positive correlation existed between SI and age, while weak negative correlation existed between SI and Garden types of femoral neck fracture classification. Conclusion Singh index can be applied as an effective method for evaluating osteoporotie hip fracture risk, especially for female femoral neck fractures. Osteoporosis is one of high risk factors in senile hip fractures. SI declines to grade IV in men, and grade III in women can be regarded as diagnosis criteria.