中老年髋部脆性骨折患者骨性关节炎的发生率及体质指数相关分析

The Preference of Osteoarthritis in Elderly Patients with Hip Fragility Fracture and Association with BMI

目的探究中老年髋部脆性骨折患者骨性关节炎(OA)发生率及其身高、体重及BMI的关系。方法将455例中老年人髋部脆性骨折患者按年龄分为两组,50~74岁组207例,男47例,女160例,≥75岁组248例,男95例,女153例。依据Kellgren-Lawrence(K/L)分级法、图谱对照,评估患者健侧髋关节X线平片,K/L≥2级为OA诊断标准。比较各年龄组患者身高、体重和BMI及骨折部位的差异;评价髋部OA发生率与患者年龄的相关性;比较男女OA组与非OA组患者身高、体重及BMI的差异;比较超重组与非超重组OA发生率的差别。结果同年龄组男女患者身高、体重差异均有统计学意义(P<0.001),≥75岁组男女BMI差异有统计学意义(P<0.05);K/L分级法对中老年髋部脆性骨折患者OA的总体检出率为10.3%(47/455),50~74岁组8.2%(17/207),≥75岁组12.1%(30/248);OA组与非OA组身高、体重及BMI差异均无统计学意义(P>0.05);髋部脆性骨折患者超重组与非超重组OA发生率无差别(P>0.05)。结论髋部脆性骨折患者OA发病率高龄组比低龄组高;女性高龄组粗隆间骨折发病率明显较低龄组高;髋部脆性骨折患者超重组与非超重组OA发生率无差别。重度OA在髋部脆性骨折患者中少见。

Objective To investigate the correlation between the incidence of osteoarthritis(OA)in elderly patients with hip fragility fracture and the anthropometric data(including body height,weight and BMI)of these patients.Methods 455 cases of the elderly hip fragility fracture patients aged 50–99 years were divided into 2 groups according to age≥75 and<55,the younger group within 207 cases(male 47 cases,female 160 cases)and the elderly group within 248 cases(male 95 cases,female 153 cases).The X-ray images of the uninjured hip of the patients were performed to evaluate hip osteoarthritis(OA)according to the Kellgren-Lawrence grade method and comparison atlas setting≥grade 2 as the diagnostic criteria for OA.The height,weight and BMI were obtained in both groups.Comparing the differences in height,weight,BMI,fracture positions of each group,the relationships between the anthropometric data and the incidence of hip OA were also evaluated.Results Differences of height and weight of both male and female patients in each group were statistically significant(P<0.001),and BMI of both males and females in the elderly group also showed significant differences(P<0.05).The detection rate of OA in the whole group of patients with hip fragility fracture was 10.3%(47/455)using K/L grade,accordingly the detection rate being 8.2%(17/207)in the younger group and 12.1%(30/248)in the elderly group.There was no significant difference in the anthropometric data between the OA group and the non-OA group(P>0.05).Conclusion The incidence of OA in patients with hip fragility fractures of elderly group was higher than the younger group.The incidence of intertrochanteric fractures of elderly group was obviously higher than that in the younger group for female patients.There were no differences in the incidence of OA between overweight and normal weight patients with hip fragility fracture.Severe hip OA is rare in patients with hip fragility fractures.