120例骨质疏松性脊柱骨折患者的危险因素调查分析

Investigation on risk factors of 120 patients with osteoporotic vertebral fractures

目的:通过对骨质疏松性脊柱骨折患者的一般情况和中医辨证分型进行调查分析,探讨其发生的危险因素,为早期预测本病的发生提供客观依据。方法:采用病例对照研究方法,随机选取骨质疏松性脊柱骨折和非骨质疏松性脊柱骨折患者各120例,分别调查两组骨密度、性别、年龄、民族、职业、既往病史、初潮年龄、绝经年龄、体重指数及日常生活方式等相关情况,并辨证分型。运用单因素方差分析、Logistic回归多因素分析,分析骨质疏松性脊柱骨折各危险因素与骨质疏松性脊柱骨折发生的相关性;按照中医辨证分型标准进行归纳,总结不同证型的分布规律。结果:两组患者的年龄、体重、体重指数、绝经年龄、孕产个数、骨密度有显著性差异(P<0.05)。两组既往冠心病史、骨折史,牛奶、浓茶饮用情况及户外运动、吸烟等比较,差异有统计学意义(P<0.05);其中冠心病史、骨折史、常饮浓茶及吸烟OR值>1.0,都为骨质疏松性脊柱骨折的危险因素之一。非条件Logistic回归多因素分析结果显示筛选出的因素有年龄、体重指数、绝经年龄、孕产个数、骨密度、性别、骨折病史、常饮浓茶,其中骨密度(低)、体重指数(低)、绝经年龄(低)及常饮浓茶(有)是骨质疏松性脊柱骨折发病的危险因素;调查病例组120例的中医证型,肾阳虚型23例,占19.2%,肝肾阴虚型12例,占10.0%,脾肾阳虚型61例,占50.8%,气滞血瘀型24例,占20.0%。两组比较,差异有显著的统计学意义。

Objective： By investigating the general situations and TCM syndromes in patients with osteoporotic vertebral fractures, some risk factors were explored, to provide an objective basis for predicting this disease early. Methods： 120 patients with osteoporotic vertebral fractures and 120 patients without osteoporotic vertebral fractures were selected; bone mineral density, gender, age, ethnicity, occupation, medical history, age at menarche, age at menopause, body mass index and lifestyle were investigated; and all patients were divided into different syndromes. By applying one-way ANOVA, Logistic regression multivariate analysis, various risk factors were analyzed; according to TCM differentiation, the distribution of different syndromes can be found. Conclusion： Differences of age, body weight, body mass index, age at menopause, the number of maternal, BMD between both groups were significant （P〈0.05）. Indexes of CHD history, fractures history, drinking milk and tea, doing outdoor exercise, smoking and others showed statistically significant differences between groups （P〈0.05）; OR values of CHD, fractures history, often drinking tea and smoke were more than 1.0, and those indexes were risk factors of osteoporotic vertebral fractures. Logistic regression multivariate analysis showed that age, body mass index, age at menopause, the number of maternal, bone density, gender, fracture history, often drinking tea were screened factors. And bone mineral density （low）, body mass index （low）, age at menopause （low） and often drinking tea （yes） were risk factors for osteoporotic vertebral fracture incidence. In 120 cases, 23 cases were the Shenyangxu type, accounting for 19.2%; 12 cases were the Ganshen Yinxu type, for 10.0%; 61 cases were the Pishen Yangxu type, for 50.8%; 24 cases were the Qizhi Xuyu type, for 20.0%. The difference was significant.