入住疗养院者骨质疏松患病及防治状况研究

Prevalence and Management Status of Osteoporosis in Nursing Home Residents

【目的】探讨美国圣路易斯州入住疗养院者骨质疏松的患病及防治状况。【方法】用定量超声骨密度测定仪测量2 17例入住疗养院者 (年龄 42～ 10 2岁 ,平均 83 3岁 )右侧跟骨的骨密度 ,结合病史及病历记录情况 ,对入住疗养院者骨质疏松防治状况进行分析。【结果】入住疗养院者的骨密度低于同年龄段的社区居民 ,骨质疏松的患病率较高 (5 8 5 %) ,只有18 4 %的疗养院入住者跟骨骨密度在青年成人骨密度均值 1个标准差内。未诊断的骨质疏松占 83 5 %,未治疗骨质疏松占6 3 0 %,只有 37 0 %的骨质疏松患者服用钙剂及 /或维生素D治疗 ,用雌激素替代或用阿伦二膦酸盐积极治疗的仅有 3 1%。【结论】疗养院入住者骨密度低、骨质疏松患病率高 ,但防治状况差。

Objective To study the prevalence and management status of osteoporosis in a sample of nursing home residents in Saint Louis of USA. Methods Right os calcaneus bone mineral density (BMD) of 217 residents aged 42 to 102 years (mean 83.3 years) was assessed with quantitative ultrasound osteodensitometry. With the medical history and records, management status of osteoporosis in nursing homes was analyzed. Results The nursing home residents were more likely to have lower BMD values and higher prevalence of osteoporosis (58.5%) compared to age-matched community-dwelling individuals. Only 18.4% had os calcaneus BMD within 1 standard deviation of the young adult mean. The undiagnosed rate was 83.5%, and untreated osteoporosis accounted for 63.0%. Only 37.0% of nursing home residents with osteoporosis were on calcium and/or vitamin D replacement, and 3.1% of them were on hormone replacement therapy or alendronate. Conclusion Nursing home residents has lower BMD and high prevalence of osteoporosis, but osteoporosis is poor managed.