老年高骨转换型骨质疏松的危险因素及康复评定

Risk factors and rehabilitation assessment of elderly high bone turnover osteoporosis

骨质疏松症(OP)常见于老年群体,易引发脆性骨折。高骨转换型OP的骨形成和骨吸收过程均表现为活跃,治疗困难,缺乏有效改善骨密度(BMD)的治疗方式。以高骨转换型OP患者为研究对象,通过治疗前的康复评定和随访研究,旨在寻找其预后的独立性影响因素。指标包括:BMD、血清铁蛋白水平、下肢肌力的站起-坐下测试(CRT)时间、Berg平衡功能量表(BBS)评分等。结果显示,血清铁蛋白每增加1个单位,发生脆性骨折的风险增加5.3%,CRT每延长1 s,发生脆性骨折的风险增加4.12倍,患者的铁蛋白水平越高,CRT越长,则预后的BMD越低,而BBS每增加1分,发生脆性骨折的风险减少15.8%。说明铁储存水平、下肢肌力和平衡能力是影响高骨转换型OP预后的独立性因素。

Osteoporosis(OP)is common in the elderly population and can easily lead to brittle fractures.The bone formation and bone resorption processes of high bone turnover OP are both active,making treatment difficult and lacking effective treatment methods to improve bone density(BMD).This study focuses on patients with high bone turnover type OP and aims to identify independent prognostic factors through rehabilitation assessment and follow-up studies before treatment.The indicators include BMD,serum ferritin level,standing sit test(CRT)time for lower limb muscle strength,Berg balance function scale(BBS)score,etc.The results show that for every 1 unit increase in serum ferritin,the risk of brittle fracture is increased by 5.3%.For every 1 second extension of CRT,the risk of brittle fracture is increased by 4.12 times.The higher the patient's ferritin level and the longer the CRT,the lower the prognosis of BMD.However,for every 1 point increase in BBS,the risk of brittle fracture is decreased by 15.8%.The iron storage level,lower limb muscle strength,and balance ability are mutually independent factors that affect the prognosis of high bone turnover type OP.