住院老年脆性骨折患者营养状况分析

Analysis of nutritional status in fragile fracture in hospitalized elderly patients

目的：评估住院老年脆性骨折患者骨折好发部位以及骨折与营养状况的关系。方法依据骨折与否将293例研究对象分为骨折组（n ＝140）和健康对照组（n ＝153），比较两组年龄、体质量、血红蛋白及骨折部位等。结果骨折组年龄（74．04±8．58）岁，健康对照组年龄（74．77±8．14）岁，两组差异无统计学意义（t ＝－0．743，P ＞0．05）；140例骨折患者中股骨颈骨折51例，占36．4％；股骨转子间骨折57例，占40．7％；其他部位骨折32例，占22．8％；骨折患者分为60～75岁（n ＝62）以及＞75岁两组（n ＝78），＞75岁组股骨颈骨折所占构成比为37．2％，股骨转子间骨折构成比为52．6％；而60～75岁组股骨颈骨折、股骨转子间骨折的构成比分别为35．5％、25．8％，两组差异有统计学意义（χ2＝18．337，P ＜0．01）；骨折组血红蛋白（117．44±20．25）g／L、血浆白蛋白（34．96±4．95）g／L、体质量（60．81±10．63）kg、体质量指数（22．83±3.54）kg／m2；健康对照组血红蛋白（136．99±17．10）g／L、血浆白蛋白（37．27±5．85）g／L、体质量（64．47±11.23）kg、体质量指数（24．24±3．88）kg／m2，骨折组较健康对照组下述指标低：血红蛋白（t ＝－8．908）、血浆白蛋白（t ＝－3．619）、体质量（t ＝－2．837）、体质量指数（t ＝－3．218），差异均有统计学意义（均 P ＜0.01）；血磷偏低，差异有统计学意义（t ＝－2．047，P ＜0．05）；血钙（t ＝0．630）以及血碱性磷酸酶（t ＝－0．550）差异均无统计学意义（均 P ＞0．05）。结论住院老年脆性骨折患者中股骨转子间骨折和股骨颈骨折所占比例较大；较差的营养状态，如低血红蛋白、低血浆白蛋白、低体质量、低体质指数是老年人脆性骨折发生的危险因素。

Objective To evaluate the relationship between fragile fracture sites in hospitalized geriatric and nutritional status.Methods On the basis of whether the fracture,293 cases were divided into fracture group（n =140）and normal control group（n =153）,51 males（36.4%）and 89 females（63.6%）in 140 fracture patients. Results The age was （74.04 ±8.58）years in the fracture group,that in the normal control group was （74.77 ± 8.14）years,there was statistically significant difference between the two groups（t =-0.743,P 〉0.05）.The femoral neck fracture was 51 cases（36.4%）and intertrochantetic fracture was 57 cases（40.7%）,and other was 32 cases （22.8%）.The patients were divided into the two groups according to the age：60 ~75 years group（n =62）and 〉75 years group（n =78）,femoral neck fracture was 37.2%,and intertrochantetic fracture was 52.6% in the group that more than 75 years old,which were 35.5% and 25.8%,respectively in 60 ~75 years group,there was statistically significant difference between the two groups（χ2 =18.337,P 〈0.01）.The hemoglobin,serum albumin weight,weight,BMI in the fracture group were （117.44 ±20.25）g/L,（34.96 ±4.95）g/L,（60.81 ±10.63）kg,（22.83 ±3.54）kg/m2 , and those in the normal control group were （136.99 ±17.10）g/L,（37.27 ±5.85 ）g/L,（64.47 ±11.23）kg, （24.24 ±3.88）kg/m2 respectively.The commonly used nutritional indicators：hemoglobin（t =-8.908）,serum albu-min（t =-3.619）,weight（t =-2.837）and BMI（t =-3.218）were lower than the normal control group（all P 〈0.01 ）,serum phosphate was lower than the normal control group,the difference was statistically singnificant （t =-2.047,P 〈0.05）.The blood calcium（t =0.630）and ALP（t =-0.550）had no statistically singnificant differences between the two groups（all P 〉0.05）.Conclusion The proportion of intertrochantetic fracture and femo-ral neck fracture were higher in hospitalized elderly patients,and malnutrition,such as lower hemoglobin,lower serum albumin,lower weight,and lower BMI were,important factors in the fragile fracture in the geriatric inpatients.