老年人骨质疏松性骨折及8年间患病率变化

OSTEOPOROTIC FRACTURE AND CHANGE OF ITS INCIDENCE IN THE ELDERLY DURING 8 YEARS

目的通过社区调查研究在中国人口老龄化较高地区老年人骨质疏松性骨折的患病率及其在不同时期的变化。方法随机选择生活在32个社区的全部60岁以上老年人12000名,逐户、逐人调查,包括查询个人医疗档案和门诊病史。漏检率控制<7%,并与8年前的调查结果进行比较。结果1997～1998年间,老年人总骨折患病率为15.92%,其中市区老年人骨质疏松性骨折总患病率为20.1%(男15.58%,女23.45%),农村老年人总患病率为8.83%(男7.04%,女9.81%)。与1989～1990年同地区的调查结果比较,老年人总骨折患病率较8年前的15.57%仅增加了0.35%,其中市区老年人骨质疏松性骨折总患病率增加了3.6%(男3.3%,女3.9%),农村地区增加了1.9%(男3.4%,女1%)。骨折患病率在≥75岁时与增龄关系密切。骨折部位在老年期前不论男性还是女性,都以前臂远端为多见。老年期男性以髋部骨折略多,女性以前臂远端、髋部和前臂远端为主,在农村男性老人在老年前期和老年期骨折无专一好发部位,髋部骨折发病率1990～1997年间基本稳定在250/10万左右。结论上海地区随着人口老龄化和社会经济的发展,骨质疏松性骨折的患病率在8年有明显增高,应加强骨质疏松症的防治研究。

Objective To study the prevalence of osteoporotic fracture and its change in the elderly at areas with higher density of aging population in China during 8 years. Methods A total of 12000 persons aged 60 and over lived in 32 communities were surveyed including their medical records by door to door and one by one. The missing rate was less than 7%. The present results were compared with those were completed in the same area 8 years ago. Results The total incidence of fracture in the elderly was 15.92%in the whole city, 20.10%(male 15.58%, female 23.45%) in the city proper, 8.83%in the rural area (male 7.04%, female 9.81%) during 1997～1998. The total incidence of fracture increased 0.35%in the whole city.Osteoporotic fracture increased 3.6%(male 3.3%, female 3.9%) in the city proper and in rural area,it increased 1.9%(male 3.4%, female 1%). The incidence of fracture was closely associated with ≥75 years age group. The most frequent sites of fracture were located at distal end of forearm before old age. In the old age period, the sites of fracture were essentially located at proximal end of femur and distal end of forearm in women, and hip fracture in men. No specifically predisposed site in men in the rural area. The incidence of hip fracture was stably limited in 250/100,000 from 1990 to 1997. Conclusions During 8 years, the incidence of osteoporotic fracture increased with the increase of aging population and economic development in Shanghai area. The prevention and management of osteoporosis should be strengthened in practice.