浙江省永康市老年髋部骨折患者的危险因素分析

Risk factors of hip fracture in elderly patients from Yongkang,Zhejiang province

目的：探讨永康市老年人髋部骨折的危险因素。方法自2014年8月至2016年8月前瞻性收集永康市骨科医院骨科收治的永康地区髋部骨折的老年患者468例作为研究组，同期随机选取至永康市骨科医院及社区卫生服务中心体检的老年人150例作为对照组。观察两组研究对象合并症、日常生活习惯、骨密度和女性月经情况。结果与对照组比较，研究组糖尿病发生率显著增高（28．63％比12．67％，χ^2＝15.544，P ＝0．000）；身高降低〉3 cm 发生率显著增高（16．88％比8．00％，χ^2＝7．134，P ＝0．008）；长期服用激素比例显著增高（18．59％比10．00％，χ^2＝6．082，P ＝0．014）；体育锻炼率显著降低（14．32％比22．67％，χ^2＝5．793，P ＝0．016）；长期卧床率显著增高（5．34％比1．33％，χ^2＝4．369，P ＝0．037）；股骨颈骨密度显著降低[（0．99±0．12）g／cm^2比（1．10±0．12）g／cm^2，t ＝10．139，P ＝0．000]。女性患者中，与对照组相比，研究组45岁之前绝经率显著增高（33．23％比22．22％，χ^2＝4．299，P ＝0．038）。结论糖尿病、身高降低〉3 cm、长期服用激素、缺乏体育锻炼、长期卧床和骨密度降低是永康市老年人髋部骨折的危险因素，女性45岁之前绝经是老年女性髋部骨折的危险因素。

Objective To explore the risk factors of hip fracture in elderly patients from Yongkang.Methods From August 2014 to August 2016,468 elderly patients with hip fracture admitted to Department of Orthopedics, Orthopedics Hospital of Yongkang were prospectively collected as study group,and 150 elderly people admitted to Orthopedics Hospital of Yongkang and Community Health Service Center for health examination were randomly selected as control group.The complications,daily living habits,bone density and menstruation of the female were observed between the two groups.Results Compared with the control group,the incidence rate of diabetes in the study group increased significantly（28.63% vs.12.67%,χ^2 =15.544,P =0.000）,the rate of height decreased more than 3cm increased significantly （16.88% vs.8.00%,χ^2 =7.134,P =0.008）,the proportion of long -term use of hormone significantly increased （18.59% vs.10.00%,χ^2 =6.082,P =0.014）,the rate of physical exercise decreased signif-icantly （14.32% vs.22.67%,χ^2 =5.793,P =0.016）,the rate of bed ridden increased significantly （5.34% vs 1.33%,χ^2 =4.369,P =0.037）,the bone density of femoral neck decreased significantly[（0.99 ±0.12）g/cm^2 vs. （1.10 ±0.12）g/cm^2 ,t =10.139,P =0.000].When it came to the females,the rate of menopause before the age of 45 years in the study group was higher than that in the control group （33.23% vs.22.22%,χ^2 =4.299,P =0.038）.Conclusion Diabetes,height decrease 〉3 cm,long -term use of hormones,lack of physical exercise,bed ridden and bone density decrease are risk factors of hip fracture in elderly people from Yongkang,and menopause before the age of 45 is a risk factor for hip fracture in elderly women.