中国五地区中老年人群脊椎骨折患病危险因素比较研究

Study on risk factors of vertebral fractures in the middle-aged and elderly population in five areas of China

目的 了解中国地区间中老年人群脊椎骨折患病危险因素 ,为脊椎骨折的社区预防和治疗提供依据。方法 采用分层多阶段整群抽样方法对中国五大行政区 5 1 0 3例 50岁以上男女人群进行胸腰椎侧位平片 ,骨密度测量和问卷调查 ,对 1 4 0余个变量进行多因素非条件 Logistic回归分析 ,得出各危险因素的比数比 (OR)。结果 五地区资料分别为 :年龄因素 (OR=1 .0 4 1 2 - 1 .1 1 58,男女 ) ,背疼史 (OR=1 .4544- 3.40 68,男 )和坐立试验困难 (OR=1 .2 2 0 0 - 1 8.561 0 ,女 )为较共同危险因素 ,骨密度 (OR=0 .0 0 2 3- 0 .0 2 0 7,男女 ) ,第一次右手握力 (OR=0 .71 70 - 0 .8474,女 )为较共同的保护性因素 ;长期卧床 (男 ) ,母亲骨质疏松史 (男 ) ,肝脏病史 (女 ) ,长期卧床年龄 (女 )等危险因素分别在不同地区出现 ;而常吃鱼类、肉类(男 ) ,垂直跳高能力 (女 ) ,居室阳光充足 (女 ) ,年轻时身高 (女 )等多为保护性因素。结论 我国五地区脊椎骨折患病危险因素中有共同的暴露因素 ,同时 ,不同地区主要危险因素和保护性因素又有一定差异。为今后脊椎骨折的防治提供参考数据。

Objectives To understand the risk factors of vertebral fractures prevalence in the middle-aged and elderly population among various areas of China. Methods By the stratified-multi-steps-cluster sampling, lateral spine films and bone mineral density (BMD) were measured and questionnaire was surveyed form 5103 people aged above 50 years old in five administrative areas of China. More than 140 variables were analyzed by the non-conditional logistic regression. Results The common risk factors were age (OR=1.0412～1.1158, male and female), history of dorsalgia (OR=1.4544～3.4068) and difficulty to sit and stand (OR=1.2200～18.5610, female) in most areas of China. The common protective factors were bone mineral density (OR=00023～0.0207, male and female) and right superiority wrist (OR=0.7170～0.8474, female). Some statistically significant correlations existed in different areas. Conclusions Some common risk factors of vertebral fractures did exist in most areas of China, but there were some particular risk factors and protective ones in every area.