广西梧州市社区老年人骨关节炎患病情况及危险因素分析

Investigation on the Prevalence and Risk Factors of Osteoarthritis among the Elderly in the Community of Wuzhou City,Guangxi

目的探究老年人骨关节炎的患病情况及流行病学趋势,分析老年人群罹患骨关节炎的危险因素,为临床筛查老年人骨关节炎提供数据参考。方法2018年1月―2022年12月在广西梧州市采用多阶段分层抽样法,选取26个社区老年人进行骨关节炎相关情况调查(内容包括问卷、体格检查和实验室检查),了解社区老年人骨关节炎的患病情况,并采用Logistic回归模型分析影响社区老年人骨关节炎患病的危险因素。结果经问卷调查最终纳入2958例老年人,其中骨关节炎患者共有1904例,总体患病率64.37%,其中下肢单病灶占比49.69%(946/1904),上肢单病灶占比16.54%(315/1904),脊柱单病灶占比20.85%(397/1904),多发病灶占比12.92%(246/1904);在2018-2022年期间老年人骨关节炎的年患病率呈逐年增长趋势(χ^(2)=10.213,P<0.05)。老年人骨关节炎患病率女性总占比明显高于男性(χ^(2)=7.564,P<0.05),且患病率随年龄的增长而明显升高(χ^(2)值分别为28.318、10.711、10.910、11.531、11.208,均P<0.05)。单因素分析发现,女性、居住楼梯房、既往体力劳作/运动史、家族史、吸烟史、骨质疏松史、糖尿病史、高血压史、慢性肾病史、心脑血管病史、BMI、年龄与社区老年人罹患骨关节炎有关(χ^(2)值分别为7.564、6.705、32.152、8.754、77.485、17.827、15.469、6.784、14.474、7.983、8.468,均P<0.05)。Logistic分析显示,女性(OR=2.620,95%CI:1.059~6.479)、居住楼梯房(OR=3.025,95%CI:1.178~7.766)、既往体力劳作/运动史(OR=3.177,95%CI:1.223~8.253)、家族史(OR=1.719,95%CI:1.051~2.812)、吸烟史(OR=2.038,95%CI:1.057~3.930)、骨质疏松史(OR=3.483,95%CI:1.336~9.083)、糖尿病史(OR=2.298,95%CI:1.100~4.802)、高血压史(OR=3.277,95%CI:1.201~8.940)、慢性肾病史(OR=2.670,95%CI:1.193~5.975)、心脑血管病史(OR=2.358,95%CI:1.015~5.478)、BMI(OR=2.096,95%CI:1.083~4.057)、年龄(OR=3.721,95%CI:1.394~9.934)均是社区老年人罹患骨关节炎危险因素(均P<0.05)。结论近五年来广西梧州市社区老年人骨关节炎的患病率逐年增长,临床可根据分析具有差异性的人口学特征、既往病史及生活史对易罹患骨关节炎病的高风险老年人进行筛查与防控。

Objective To explore the prevalence and epidemiological trend of osteoarthritis in the elderly,and to analyze the risk factors of osteoarthritis in the elderly,so as to provide data reference for clinical screening of osteoarthritis in the elderly.Methods From January 2018 to December 2022,a survey of osteoarthritis was conducted among the elderly in 26 communities in Wuzhou city,Guangxi by multi-stage stratified sampling(including questionnaire,physical examination and laboratory examination)to understand the prevalence of osteoarthritis in the el-derly in the community.Logistic regression model was used to analyze the risk factors of the elderly in the community.Results A total of 2958 elderly patients with osteoarthritis were included in the questionnaire,including 1904 patients with osteoarthritis,with an overall prevalence rate of 64.37%.Single focus of lower limb accounted for 49.69%(946/1904),upper limb single focus accounted for 16.54%(315/1904),single focus of spine accounted for 20.85%(397/1904),multiple lesions accounted for 12.92%(246/1904).The annual prevalence rate of osteoarthritis increased year by year from 2018 to 2022(χ^(2)=10.213,P<0.05).The total prevalence rate of osteoarthritis in the elderly is significantly higher in females than in males(χ^(2)=7.564,P<0.05).And the prevalence rate increased significantly with the increase of age(χ^(2)=28.318、10.711、10.910、11.531、11.208,P<0.05).Univariate analysis showed that female,living stairwell,previous physical work/exercise history,family history,smoking history,osteoporosis history,diabetes history,hypertension history,chronic kidney disease history,cardio-cerebrovascular disease history,BMI and age were associated with osteoarthritis among the elderly in the community(χ^(2)=7.564、6.705、32.152、8.754、77.485、17.827、15.469、6.784、14.474、7.983、8.468,P<0.05).Logistic analysis showed that female(OR=2.620,95%CI:1.059-6.479),living stairwell(OR=3.025,95%CI:1.178-7.766),previous physical work/exercise history(OR=3.177,95%CI:1.223-8.253),family history(OR=1.719,95%CI:1.051-2.812),smoking history(OR=2.038,95%CI:1.057-3.930),osteoporosis history(OR=3.483,95%CI:1.336-9.083),diabetes history(OR=2.298,95%CI:1.100-4.802),hypertension history(OR=3.277,95%CI:1.201~8.940),chro-nic kidney disease history(OR=2.670,95%CI:1.193-5.975),cardio-cerebrovascular disease history(OR=2.358,95%CI:1.015-5.478),BMI(OR=2.096,95%CI:1.083-4.057)and age(OR=3.721,95%CI:1.394-9.934)were all risk factors for osteoarthritis among the elderly in the community(P<0.05).Conclusion In the past 5 years,the prevalence rate of osteoarthritis among the elderly in the community of Wuzhou,Guangxi city is increasing year by year.According to the analysis of different demographic characteristics,past medical history and life history,we can screen,prevent and control the high-risk elderly who are prone to osteoarthritis.