2015-2017年北京市成年骨关节炎患者主要合并症的流行病学研究

Epidemiology of major comorbidities in adult patients with osteoarthritis in Beijing from 2015 to 2017

目的探究北京市成年骨关节炎患者合并症的流行病学现况及相关因素。方法利用2015-2017年北京市所有定点医疗机构的就诊数据,收集成年骨关节炎患者的相关资料,对成年骨关节炎患者2型糖尿病、抑郁症、高血压、血脂异常等常见合并症的患病情况进行统计描述与分析,比较不同社会人口特征的人群中合并症患病情况的差异。结果共纳入3048304例成年骨关节炎患者,年龄(58.2±14.5)岁,女性占62.2%。患有至少一种常见合并症的骨关节炎患者占79.8%,其中男性患者出现合并症(82.6%)的比例高于女性(78.1%)。骨关节炎患者合并症患病率在不同年龄组间差异有统计学意义(P<0.05),年龄越大,合并症患病率越高。农村骨关节炎患者合并症的患病率(82.7%)高于城市(78.8%)。骨关节炎患者合并症的患病率从高到低依次为高血压68.0%,血脂异常63.8%,2型糖尿病36.3%,抑郁症8.2%。男性患者比女性患者更容易伴发的合并症依次为高血压、血脂异常、2型糖尿病,女性患者比男性患者更容易伴发抑郁症。有1种、2种、3种及以上合并症的骨关节炎患者所占比例分别为17.7%,30.7%、31.4%。男性(OR=1.15,95%CI:1.14-1.16)、≥55岁(OR=1.07,95%CI:1.07-1.07)、农村地区(OR=1.66,95%CI:1.64-1.67)、从事体力劳动(OR=1.02,95%CI:1.01-1.02)的骨关节炎患者患合并症的风险较高。结论北京市成年骨关节炎患者血脂异常、高血压、2型糖尿病等合并症的患病率较高,应重点关注中老年及农村地区的骨关节炎患者。

Objective To explore the epidemiological status and related factors for comorbidities of osteoarthritis(OA) among adult residents in Beijing. Methods Based on the medical records of all designated medical institutes in Beijing from 2015 to 2017, relevant data of adult OA patients were collected, and the prevalence of major comorbidities such as type 2 diabetes, depression, hypertension and dyslipidemia in this population was statistically described and analyzed, and the differences among populations with different sociodemographic characteristics were compared. Results A total of 3 048 304 adult OA patients were included, with a mean age of 58.2±14.5 years, and females accounting for 62.2%. 79.8% of the subjects had at least 1 comorbidity, with the males(82.6%) having a higher prevalence than the females(78.1%). The prevalence of OA comorbidities was increased with age and statistically significant among different age groups(P<0.05). The prevalence in the patients living in the rural areas(82.7%) was higher than that in urban areas(78.8%). The top 4 most common comorbidities were hypertension(68.0%), dyslipidemia(63.8%), type 2 diabetes(36.3%), and depression(8.2%). The males were more likely to suffer from hypertension, dyslipidemia and type 2 diabetes, while the females from depression. The proportion of OA patients with 1, 2, 3 or more kinds of comorbidities was 17.7%, 30.7%, 31.4% respectively. The risk factors for OA comorbidities included: male(OR=1.15, 95%CI: 1.14~1.16), ≥55 years old(OR=1.07, 95%CI: 1.07~1.07), living in rural areas(OR=1.66, 95%CI: 1.64~1.67), and taking manual labor(OR=1.02, 95%CI: 1.01~1.02). Conclusion The adult OA patients in Beijing have relatively high prevalences of comorbidities, including dyslipidemia, hypertension, type 2 diabetes and other diseases. More attention should be paid to the middle-aged and elderly patients and those in rural areas.