绝经后女性椎体骨折的临床特征及危险因素分析

Analysis on clinical characteristics and risk factors of vertebral fracture in postmenopausal women

目的观察绝经后女性椎体骨折的临床特征,分析可能导致骨折的危险因素,为绝经后女性椎体骨折的防治提供参考。方法选取2015年3月-2018年6月天津市红桥区中医医院收治的200例绝经后椎体骨折女性患者作为骨折组,另选取同期在该院接受常规体检的绝经后健康女性100例作为未骨折组,使用该院自制绝经后女性一般问卷调查全部受检者一般资料,包括患者基本信息、日常生活习惯、骨折情况等;同时为全部受检者实施血清学实验室相关指标检查,包括常规生化指标及骨代谢特异生化指标等;为受检者实施骨密度检查,分析绝经后女性椎体骨折的临床特征,采用单因素及多因素分析找出可能导致绝经后女性椎体骨折的危险因素。结果 200例绝经后椎体骨折女性患者,骨折椎体共318个,以T11~L1椎体部位骨折发生率最高,患者椎体骨折分度多为1度,随年龄的增加骨折率呈升高趋势,患者整体骨代谢指标水平偏高、血肌酐(Cr)及血清碱性磷酸酶(ALP)表达偏低、各部位骨密度均较低、骨质疏松整体患病率高、服用抗骨质疏松药物占比低。经单因素与多因素Logistic逐步回归分析证实,高龄、整体骨密度低、既往有椎体骨折史可能是导致绝经后女性椎体骨折的危险因素(OR>1,均P<0. 05)。结论绝经后女性椎体骨折好发于T11~L1椎体,以老年人群为主,患者骨强度低,骨代谢指标不同程度异常,高龄、既往椎体骨折史、骨密度低可能是其主要危险因素,临床应重视绝经后女性骨密度的检测,并定期对骨折高危人群开展骨折筛查,便于绝经后女性椎体骨折的早期防治,降低骨折率。

Objective To observe the clinical characteristics of vertebral fracture in postmenopausal women,analyze the risk factors,provide a reference for prevention and treatment of vertebral fracture in postmenopausal women.Methods From March 2015 to June 2018,200 postmenopausal women with vertebral fracture treated in Hongqiao District Hospital of Traditional Chinese Medicine were selected as fracture group,100 healthy postmenopausal women receiving routine physical examination in the hospital during the same period were selected as non-fracture group.A self-designed postmenopausal women questionnaire was used to ssurvey the general situations of the women in the two groups,including basic information,daily living habits,and fracture situation.Serological indexes were detected,including routine biochemical indexes,and specific biochemical indexes of bone metabolism.Bone density examination was performed.The clinical characteristics of vertebral fracture in postmenopausal women were analyzed.Univariate analysis and multivariate analysis were performed to find the risk factors of vertebral fracture in postmenopausal women.Results Among 200 postmenopausal women,318 vertebral bodies were fractured.The incidence rates of fracture of T11-L1 vertebral bodies were the highest,grade I fracture was the most common type.The incidence rate of vertebral fracture increased with age.The levels of bone metabolism indexes were high,the levels of serum creatinine(Cr)and alkaline phosphatase(ALP)were low,the levels of bone density of different parts were low,the total incidence rate of osteoporosis was high,the application rate of anti-osteoporosis drug was low.Univariate analysis and multivariate Logistic stepwise regression analysis showed that advanced age,total low bone density,history of vertebral fracture were risk factors of vertebral fracture in postmenopausal women(OR>1,P<0.05).Conclusion Vertebral fracture mainly occurs in T11-L1 vertebral bodies of postmenopausal women,the incidence rate is high among old women.Among the postmenopausal women with vertebral fracture,bone strength is low,the indexes of bone metabolism are abnormal.Advanced age,history of vertebral fracture,low bone density are main risk factors.More attention should be paid to detection of bone density among postmenopausal women,fracture screening should be conducted regularly among the high-risk population to promote early prevention and treatment of vertebral fracture and reduce the incidence rate.