绝经后骨质疏松症发生骨折的影响因素Logistic回归分析

Logistic regression analysis on influencing factors of fractures secondary to postmenopausal osteoporosis

目的 探讨绝经后骨质疏松症女性患者发生骨折的影响因素.方法 分析我院就诊的500例绝经后骨质疏松症女性患者的临床资料,对发生骨折（157例）和未发生骨折（343例）的病例进行组间对照研究,并对7种可能影响绝经后骨质疏松性骨折发生的因素进行Logistic回归分析.结果 （1）单因素分析结果显示：身高和绝经时间与骨折发生率无明显相关（t身高=0.305,P＞0.05;t绝经=-1.240,P＞0.05）,而年龄、体重、肌肉厚度、肌力和骨密度与骨折发生率显著相关（t年龄=3.132,P ＜0.01;t体重 =2.136,P＜0.05;t肌肉厚度=-8.829,P＜0.01;t肌力=-4.369,P＜0.01;t骨密度=-9.651,P＜0.01）;（2）Logistic回归分析提示：年龄、体重、肌肉厚度、肌力和骨密度均为绝经后骨质疏松性骨折发生率的独立相关因素（P＜0.01）,且肌肉厚度、肌力和骨密度为保护因素（β肌肉厚度=-2.575;β肌力=-0.022;β骨密度=-9.982）,而年龄和体重为危险因素（β年龄=0.078;β体重=0.054）.结论 年龄和体重越大的绝经后骨质疏松症患者发生骨折的风险性较大,而骨密度、肌力和肌肉厚度越大的绝经后骨质疏松症患者发生骨折的风险则越小,临床上可针对这3个保护因素进行预防性干预,以期达到降低骨质疏松性骨折发生率的作用。

Objective To explore the influencing factors of fracture caused by postmenopausal osteoporosis.Methods Clinical features of 500 patients with postmenopausal osteoporosis hospitalized during June 2013 to June 2015 were reviewed and analyzed.All cases with or without fractures were analyzed by case-control study and Logistic regression analysis for 7 influencing factors of fractures was made.Results （1） Univariate analysis revealed that height and time of menopause had no marked relation with incidence of fracture （tHeight =0.305,P 〉 0.05;tMenopause =-1.240,P 〉 0.05）,while age,weight,muscle thickness,muscle force and bone mineral density （BMD） had marked relation with incidence of fracture （tAge =3.132,P〈 0.01;tWeight =2.136,P〈 0.05;tMuscle thickness =-8.829,P〈 0.01;tMuscle force =-4.369,P 〈 0.01;tBMD =-9.651,P 〈 0.01）;（2） Logistic regression analysis showed that age,weight,muscle thickness,muscle force and BMD were the independent correlation factors of fracture （P 〈0.01）.Moreover,muscle thickness,muscle force and BMD were the protective factors of fracture （βMuscle thickness =-2.575;βMusele force =-0.022;βBMD =-9.982）,while age and weight were the dangerous factors of fracture （βAge =0.078;βweighi =0.054）.Conclusion Postmenopausal osteoporosis patients with advanced age and overweight are of great risk of fracture,while patients with higher BMD,greater muscle force and thicker muscle thickness,will have smaller risk of fracture.We can carry out preventive treatment from the three protective factors to reduce the incidence of osteoporotic fracture.