儿童髋关节发育不良相关危险影响因素研究

Risk factors related to hip dysplasia in children

目的探讨影响本地区人群髋关节发育不良发生的部分相关危险因素。方法采用病例对照分析法。收集2017年5月至2017年10月来自郑州市骨科医院对河南某地区所普查的466例髋关节发育异常儿童。将髋关节发育异常(包含发育不良、半脱位、脱位及坏死者)儿童视为病例组,采用简单随机抽样法、按照1∶1的匹配方法抽取健康儿童,视为对照组。采用SPSS 19.0对数据进行录入分析对髋关节发育不良儿童的年龄分布、性别等资料进行统计描述;分别采用χ^(2)检验及Mann-Whitney U检验,对病例组与对照组组间危险因素进行对比分析;以DDH结局为因变量、以单因素分析作用有统计学意义的8个变量为自变量进行多因素Logistic回归统计分析。结果全县共筛查DDH儿童466例,患病率约为11‰。DDH的发生与胎儿宫内位(χ^(2)=10.244,P<0.01)、出生绑腿习惯(χ^(2)=21.274,P<0.01)、DDH家族史(U=3839.500,Z=-21.321,P<0.01)等8个因素有关,未发现DDH与生产方式、出生后常用抱姿、孕期母亲是否生病服药、父母有无不良嗜好、孕前孕期父母是否从事有关放射及化学类工作等10项因素有关。多因素Logistic回归分析结果显示,胎儿宫内位、包被绑腿习惯、父母出生地(在本县)及DDH家族遗传史4个研究因素与DDH患病存在关联(P值均<0.05)。结论有多种因素及DDH家族遗传史与儿童髋关节发育不良的发病相关,了解这些因素对于儿童髋关节发育不良的预防具有积极意义。

Objective To analyze and explore some risk factors of hip dysplasia in children aged 0-8 years,and to provide some references for the prevention of hip dysplasia.Methods Case-control method was used in this study.A total of 466 children with dysplasia of hip joint were collected from Zhengzhou Orthopaedic Hospital from May 2017 to October 2017 in a district of Henan province.Children with dysplasia of hip joint(including dysplasia,subluxation,dislocation and bad death)were regarded as the case group,and healthy children were selected according to 1∶1 matching method by simple random sampling method and regarded as the control group.SPSS 19.0 was used for data entry analysis.Age distribution,gender and other data of children with hip dysplasia were statistically described.The risk factors between the case group and the control group were analyzed by χ^(2) test and Mann-Whitney U test,respectively.Multivariate Logistic regression analysis was conducted with DDH outcome as the dependent variable and 8 variables with statistical significance in univariate analysis as the independent variables.Results A total of 66 DDH patients were screened in the country,and the prevalence rate was about 11 per 1000.The occurrence of DDH was related to 8 factors such as fetal intrauterine position(χ^(2)=10.244,P<0.01),birth leggings habit(χ^(2)=21.274,P<0.01),DDH family(U=3839.500,Z=-21.321,P<0.01),etc.DDH was not found to be related to 10 factors,such as mode of birth,commonly used postnatal posture,whether the mother took medicine during pregnancy,whether the parents had bad habits,and whether the parents engaged in radiation and chemical work before pregnancy.The results of multivariate Logistic regression analysis showed that fetal intrauterine position,binding habit,parents’place of birth(in this county)and DDH family genetic history were associated with DDH(all P<0.05).Conclusion Various factors and family history of DDH are associated with the incidence of hip dysplasia in children.Understanding these factors has positive significance for the prevention of hip dysplasia in children.