老年人髋部骨折的骨密度及影响因素的分析

Analysis of the change of BMD and the influential factors for hip fracture in the elderly people.

目的 调查分析成都地区老年人髋部骨折骨密度变化和影响因素 ,为预防髋部骨折提供科学依据。方法 骨折组答卷式调查有关指标 ,髋部作 X线正斜侧位摄片 ,骨折组与非骨折组进行配对 ,均用 DEXA测量 L2～ 4,股骨上段骨密度 (BMD) ,骨矿含量 (BMC) ,骨面积 (Area)等 ,并进行统计分析。结果 股骨上段及 L2～ 4的 BMD、BMC骨折组明显低于非骨折组 (P<0 .0 5 ) ,两组各进行男女性比较 ,女性均明显低于男性 (P<0 .0 5 ) ,骨折组 L2～ 4BMD男、女分别为 0 .872±0 .178g/ cm2 ,0 .6 0 7± 0 .15 5 g/ cm2 ;非骨折组男女分别为 0 .92 1± 0 .147g/ cm2 ,0 .741± 0 .15 2 g/ cm2。同性别的骨面积 Area两组比较无差异 ,骨折组骨质疏松症发生率 76 %明显高于非骨折组 6 3% (P<0 .0 5 ) ;滑倒和被人撞倒股骨颈骨折发生率较高 ,自行拌倒者粗隆间骨折发生率较高。结论 预防治疗骨质疏松症和避免摔倒 ,以防骨折的发生。

Objective To survey and analyze the change of bone mineral density (BMD) and the influential factors for hip fracture in the elderly patients of Chengdu region and hence provide scientific basis for the prevention of hip fracture.Methods Sixty seven patients with hip fracture were included,and to each of them were matched two non fracture persons as controls.Questionnaire was used for the situation of tumble and all the persons were examined for BMD,bone mineral content (BMC)and Area of L 2～4 Neck,Troch,Wards.Results The BMD and BMC of L 2～4 and neck in the fracture group were significantly lower than those in the non fracture group ( P <0.05),but there was no difference in BMC between the two groups.The rate of osteoporosis in fracture group(76%)was higher than that in non fracture group( P <0.05).The location of fracture varied with the situation of tumble.Conclusion Enhancing BMD and avoiding tumble are essential for the prevention of hip fracture in elderly people.