上海浦东某社区综合干预对骨质疏松症患者的防治研究

Comprehensive community intervention programme for community-dwelling elderly with osteoporosis in Lujiazui District,Shanghai City

目的为了解上海浦东新区某社区老年居民对原发性骨质疏松症（PO,Primary Osteoporosis）的认知情况,评价社区综合干预措施的效果。方法选取该社区160例50岁以上的在2014年2-5月被诊断为PO的患者,随机分为对照组和社区综合干预组,随访1年。1年内定期监测骨源性碱性磷酸酶（NBAP）、尿钙/肌酐（Ca/Cr）、骨密度（BMD）和福善美药物占有率（MPR）。结果 83.70%的患者对PO认识不足,无日常防治措施。与基线值及同期对照组相比,干预组患者1年后的NBAP和BMD明显增高,尿Ca/Cr明显降低（P〈0.05）。与基线值相比,对照组1年后的NBAP、BMD降低,尿Ca/Cr增高（P〈0.05）。干预组的MPR较同期对照组明显改善（P〈0.05）。结论社区综合干预措施能明显提高居民对骨质疏松症的认识,可有效避免骨质疏松症所带来的骨折等并发症,改善老年居民生活质量。

Objective The aim of the present study was to investigate the understanding of primary osteoporosis （PO） in the community-dwelling elderly in Shanghai, China, and examine the effect of comprehensive community intervention for PO patients. Methods One hundred and sixty PO patients of 50 years old or above were recruited from the community of Lujiazui in Shanghai from February 2014 to May 2014. They were randomly divided into two groups： the control group and the comprehensive community intervention group, and were followed up for one year. NBAP, Urinary Ca/Cr, BMD and Fosamax medication possession ratio were monitored periodically during the one-year follow-up. Results 83.70% of the patients had insufficient awareness of PO knowledge, and without any daily prevention measures. Compared with the baseline and the control group at the same period, NBAP and BMD of the intervention group increased significantly after 1 year, while the urinary Ca / Cr significantly declined （P 〈 0. 05 ）. In addition, compared with baseline, NBAP and BMD in the control group significantly decreased after 1-year follow-up, but urine Ca/Cr significantly increased. Compared with the control group, MPR in the intervention group significantly increased at the same period. Conclusion Comprehensive community intervention could significantly improve the understanding of OP among the community- dwelling elderly, avoid fracture induced by OP and other complications, therefore, ameliorate the quality of life of the OP patients.