原发性冻结肩危险因素的病例对照研究

Case Control Study on the Risk Factors of Primary Frozen Shoulder

目的:探讨肩周炎的相关危险因素,为肩周炎的病因学研究提供线索,为肩周炎的预防、治疗和预后提供临床依据。方法:采用以医院为基础1∶1配比的病例对照研究。病例组来自2012年1月至2013年6月在上海市静安区中心医院中医科收治的肩周炎住院患者100例。对照组是同期前往医院探望病人的健康人群或无肩部疾病的就诊患者,对照组与病例组年龄相差5岁以内1∶1匹配,共100例。根据性别、职业、既往疾病等制定调查问卷,通过面谈对潜在的肩周炎发病的危险因素进行信息收集。数据资料应用SPSS17.0统计软件进行分析,筛选出影响肩周炎的危险因素。结果:1)糖尿病、轻微外伤史、甲状腺疾病、颈椎病是有意义的变量,可能与肩周炎发病有关联,OR(95.0%CI)值分别是3.8(1.419,10.177),4.25(1.430,12.630),2.1(0.989,4.459),2.273(1.118,4.619)。2)多因素逐步分析,轻微外伤史和糖尿病是肩周炎发病的独立危险因素,OR(95.0%CI)值分别是3.747(1.227,11.446),3.381(1.23,9.295)。3)职业、体育运动、胆囊炎、手术史、缺血性心脏病等相关因素在两组间比较差异无统计学意义。结论:糖尿病、肩部外伤史、甲状腺疾病和颈椎病是肩周炎发病的危险因素,其中糖尿病和肩部外伤史是独立的危险因素。

Objective：To examine the associated risk factors of frozen shoulder,to provide clues for the study of the etiolo- gy of frozen shoulder, and to provide clinical basis for prevention, treatment, and prognosis of frozen shoulder. Methods：We performed a ratio of 1 ： 1 hospital-based case-control study involving 100 patients with pathologically diagnosed frozen shoulder and 100 patients hospitalized during the same time period with non-shoulder related complaints who were recrui- ted as controls. Information on potential risk factors was collected on both case and control groups through questionnaires and face-to-face interview. Univariate and multivariate logistic regression analyses were performed. Results：Multivariate a- nalysis suggested that diabetes and history of slight trauma were independent risk factors for the disease. The frozen shoulder patients also had a higher prevalence of thyroid disease,and cervical spondylosis than the controls. The incidence of frozen shoulder was higher in female compared to male patients. No significant difference was found in occupations,physical exercise, cholecystitis, history of surgical and ischemie heart disease between the frozen shoulder group and the control group. Conclusion： The findings in the present study indicate that diabetes, history of slight shoulder trau- ma,thyroid disease,and cervical spondylosis are factors sig- nificantly associated with increased frozen shoulder risk.