478例股骨头坏死患者流行病学调查研究

Epidemiological study of 478 patients with osteonecrosis of the femoral head

目的探讨股骨头坏死(ONFH)的临床特点及影响因素。方法分析确诊为ONFH的478例接受手术治疗患者的临床资料,包括一般资料、ONFH的病因、血脂水平及病程时间、接受保髋治疗或全髋置换的患者数量等,将数据录入信息表格并进行统计和分析。结果478例患者中,男性与女性的年龄均值差约7岁,差异有统计学意义(P<0.01),男性发病年龄的高峰在40~49岁,而女性发病年龄的高峰在50~69岁。患者血脂水平甘油三酯平均值高于正常范围值,男性与女性比较差异有统计学意义(P<0.05)。高密度脂蛋白平均值男性与女性比较差异有统计学意义(P<0.05)。总胆固醇、低密度脂蛋白平均值在正常范围值内,且男性与女性比较差异均无统计学意义(P>0.05)。25-羟基维生素D(25-OH-D)平均值低于正常范围值,男性与女性比较差异无统计学意义(P>0.05)。病程男性与女性比较差异无统计学意义(P>0.05)。接受全髋置换治疗的患者病程较保髋治疗患者病程长约35个月,差异有统计学意义(P<0.05)。ONFH患者病因中,激素性占11.92%,酒精性占25.94%,创伤性占7.53%,特发性占54.61%。结论ONFH多见于青壮年,好发于男性,可能与脂质代谢紊乱和25-OH-D降低有关,应高度重视对ONFH的早期诊断。

Objective To explore the clinical characteristics and influencing factors of osteonecrosis of the femoral head(ONFH).Methods The clinical data of 478 patients diagnosed with ONFH who received surgery were analyzed,including general data,etiology of ONFH,blood lipid level and course time,number of patients receiving hip-preserving or total hip replacement,etc.Enter the data were recorded into the information table and performed statistics and analysis.Results Among the 478 patients,the mean age difference between males and females was 7 years,with a statistically significant difference(P<0.01).The peak age of onset was 40~49 years for males and 50~69 years for females.The mean blood lipid triglyceride level was higher than the normal range,the difference was statistically significant between the male and female(P<0.05).The difference of high-density lipoprotein between male and female was statistically significant(P<0.05).The mean values of total cholesterol and low-density lipoprotein were in the normal range,and there was no significant difference between male and female(P>0.05).The average value of 25-hydroxyvitamin D(25-OH-D)was lower than the normal range,there was no statistically significant difference between male and female(P>0.05).There was no statistically significant in the course of disease difference between male and female(P>0.05).The course of disease of patients receiving total hip replacement therapy was about 35 months,which was longer than that of patients receiving hip preservation therapy,and the difference was statistically significant(P<0.05).In the etiology of ONFH,11.92%was hormonal,25.94%was alcoholic,7.53%was traumatic and 54.61%was idiopathic.Conclusions ONFH is more common in young adults and is more common in male,which may be related to lipid metabolism disorder and reduction of 25-OH-D.The early diagnosis of ONFH should be attached great importance.