Kümmell’s病相关危险因素分析

An analysis on risk factors related to Kümmell’s disease

[目的]探讨Kümmell’s病发生的相关危险因素。[方法]2009年7月一2019年1月,90例Kümmell’s病患者和90例骨质疏松压缩性骨折非手术治疗未发生Kümmell’s病患者作为研究对象。记录患者一般与临床资料,单项因素比较Kümmell’s病与非Kiimmeirs病的各项资料。以是否发生Kümmell’s病的二分变量为因变量,其他因素为自变量,行二兀多因素逻辑回归分析。[结果]骨质疏松压缩性骨折主要发生在T_(11)、T_(12)和L_(1)节段,单椎体骨折比多椎体骨折更容易发生Kümmell’s病。单因素比较表明,两组在骨密度、是否抗骨质疏松治疗情况、是否糖尿病、是否甲状腺疾病史、是否糖皮质激素服用史及是否独居的差异有统计学意义。逻辑回归表明:独居(OR=8.19,95%CI:4.81-31.25,P<0.001)、服用糖皮质激素(OR=36.07,95%CI:3.08-422.57,P<0.001)、有甲状腺疾病史(OR=5.51,95%CI:1.59-19.14,P<0.001)、高BMI(OR=3.48,95%CI:1.22-9.89,P=0.019)、低骨密度(OR=3.07,95%CI:1.10-7.37,P=0.036)是Kümmell’s病发生的危险因素;而抗骨质疏松治疗(OR=0.159,95%CI:0.03-0.24,P<0.001)是Kümmell’s病发生的保护性因素。[结论]低骨密度值、甲状腺疾病史、糖皮质激素服用史、独居及高BMI值是Kümmell’s病发生的危险因素;抗骨质疏松治疗是其保护因素。

[Objective]To explore the related risk factors of Kümmell’s disease.[Methods]From July 2009 to January 2019,90 patients with Kümmell’s disease and 90 patients with osteoporotic compression fractures without Kümmell’s disease were enrolled into this study.As the general and clinical information were collected and recorded,univariate comparison was conducted between the Kümmell’s disease group and non-Kümmell’s disease group,in addition,a binary multivariate logistic regression analysis was performed by using the dichotomous variable of whether Kümmell’s disease was diagnosed as the dependent variable and other factors as the independent variables.[Results]Osteoporotic compression fractures mainly occurred in the T_(11),T_(12) and L_(1) segments.Single-vertebral body fractures were more likely to develop Kümmell’s disease than multi-vertebral body fractures.In term of univariate comparison,there were statistically significant differences between the two groups in bone density,anti-osteoporosis treatment,diabetes,thyroid disease history,glucocorticoid use history,and living alone(P<0.05).As results of logistic regression,the living alone(0R=8.19,95%CI:4.81-31.25,P<0.001),history of taking glucocorticoids(OR=36.07,95%CI:3.08-422.57,P<0.001),history of thyroid disease(OR=5.51,95%CI:1.59-19.14,P<0.001),high BMI(OR=3.48,95%CI:1.22-9.89,P=0.019),and low bone density(OR=3.07,95%CI:1.10-7.37,P=0.036)were of risk factors for Kümmell’s disease;whereas anti-osteoporosis treatment(OR=0.159,95%CI:0.03-0.24,P<0.001)was of a protective factor for Kümmell’s disease.[Conclusion]Low bone mineral density,history of thyroid disease,history of glucocorticoid use,living alone and high BMI are risk factors for Kümmell’s disease,however,anti-osteoporosis treatment is its protective factor.