高原地区老年低能量损伤所致腰椎骨折的影响因素分析

Analysis of factors of elder patients with lumbar vertebrae fractures caused by low-energy injury in plateau area

目的调查高原地区老年低能量损伤所致腰椎骨折情况并分析其影响因素。方法2013年3月至2016年9月间青海省人民医院骨科收治的低能量损伤所致腰椎骨折患者124例为观察组，以同期无骨折的老年体检者98例为对照组，采用全身骨密度检查仪对其骨密度（BMD）情况进行检查，采用单因素和多因素Logistic回归分析患者发生腰椎低创伤性骨折的影响因素。结果观察组腰椎侧位BMD值及丁值明显低于对照组（P〈0．05）；单因素分析显示，患者年龄、体质指数、既往史、骨密度、补钙史对腰椎低创伤性骨折有明显影响；经Logistic回归分析显示，年龄（OR=1．215）、骨密度（OR=3．215）、补钙史（OR=4．904）是腰椎低创伤性骨折的独立危险因素（P〈0．05）。结论高原地区老年骨密度值较普通同龄人群明显下降，年龄、骨密度及补钙史是低能量损伤所致腰椎骨折的独立危险因素，需据此进行个体化的医学干预。

Objective To analyse the factors of elder patients with lumbar vertebrae fractures caused by low-energy injury in plateau area. Methods From March 2013 to September 2016,124 elder patients with lumbar vertebrae fractures caused by low-energy injury in our hospital were selected as observation group, in the corresponding period, 98 elderly patients who had no fractures were considered as control group. The bone mineral density （BMD） was examined by whole body bone mineral density tester, and univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of lumbar fractures caused by low-energy injury. Results BMD and T value of lateral projection of lumbar vertebrae in observation group were significantly lower than those in control group （ P 〈 0. 05 ）. Single factor analysis showed that the age, body mass index, past history, bone mineral density and calcium supplementation had a significant effect on lumbar fractures caused by low-energy injury. Logistic regression analysis showed that age （ OR = 1. 215 ）, bone mineral density （ OR = 3. 215 ） and calcium supplementation （ OR = 4. 904） were independent risk factors for lumbar fractures caused by low-energy injury （ P 〈 0. 05 ）. Conclusion Bone mineral density of elderly population in plateau area is lower. Age, bone mineral density and calcium supplementation are independent risk factors of lumbar fractures caused by low-energy injury, and individual medical intervention is needed.