少数民族地区居民股骨头坏死患病及影响因素分析

Prevalence and influencing factors of femoral head osteonecrosis in minority populations

目的了解黔南地区少数民族农村居民股骨头坏死患病现状及其影响因素，为预防和控制股骨头坏死提供依据。方法于2011年6月—2012年6月对整群随机抽取的98921名黔南地区20—69岁农村常住居民进行问卷调查和髋关节检查，体检阳性体征者摄髋关节正位及蛙位X线片，对具有髋部症状但X线片未见异常者采用核磁共振成像检查，确诊股骨头坏死。结果98921名常住居民中，经确诊的股骨头坏死患者147例，患病率为0．14％，男性和女性患病率分别为0．14％和0．18％，差异无统计学意义（x2=1．20，P〉0．05）；Ficat分期Ⅰ期19例（19髋），占12．91％，Ⅱ期89例（90髋），占60．54％，Ⅲ期17例（18髋），占11．56％，Ⅳ期22例（23髋），占14．97％；多因素logistic叫归分析结果表明，年龄、文化程度、居住环境、民族、饮酒、饮酒量、饮酒浓度、激素应用是患股骨头坏死的主要危险因素。结论黔南地区少数民族农村居民股骨头坏死患病率明显高于国内其他地区，应该引起重视。

Objective To examine the prevalence and influencing factors of femoral head osteonecrosis among rural minority residents in Qiannan Autonmous Region and to provide evidences for prevention and control of osteonecrosis. Methods A questionnaire survey and hip joint check were carried out among 98 921 rural permanent residents age 20 - 69 years randomly selected from Qiannan Buyi and Miao Autonomous Prefecture from June 2011 to June 2012. Normo- topia and frog position X-ray examination of hip joint was conducted for the residents with positive signs of osteonecrosis in physical examination and magnetic resonance imaging（MRI） was performed for the suspected patients without definite diagnosis based on the X-ray examination. Results Totally 147 femoral head osteonecrosis patients were identified among the residents, with a prevalence rate of 0. 14% and without significant gender difference in the prevalence rate （ 0. 14 % for the males and 0. 18 % for the females ;X2 = 1.20, P 〉 0.05 ）. Among the patients diagnosed, the proportion of Ficat stage Ⅰ , Ⅱ, Ⅲ ,and Ⅳ were 12.91% （ 19 cases/19 hip joints） ,60. 54% （89/90） ,11.56% （17/18） ,and 14. 97% （22/23）, respectively. Multivariate logistic regression results showed that the main risk factors of femoral head osteone- crosis were age, education level, living environment, nationality, alcohol drinking, amount of alcohol consumption, alcohol content of liquor consumed, and hormone medication. Conclusion The prevalence of femoral head osteonecrosis among rural minority residents in Qiannan prefecture is significantly higher than that in other regions of China and should be concerned.