老年妇女骨质疏松性髋部骨折的危险性预测  

Risk prediction of osteoporotic hip fracture in elderly women

作　　者：肖德明[1] 林博文[1] 程继武[1] 王巨[1] 钟紫茹[1] 黎伟凡[1] 卢小虎[1] 谢伟平[1] 麦汉溪[1] 张晓明[1] 徐忠世[1] 潘晓华[1] 陈蓟[1] 吕猛[1] 胡新佳[1] 陈基敏[1] 陈嘉凯[1] 

机构地区：[1]深圳市人民医院骨科深圳市骨科研究所,518020

出　　处：《中国老年保健医学》2005年第1期7-11,共5页Chinese Journal of Geriatric Care

摘　　要：目的探讨老年妇女骨质疏松性髋部骨折的危险性因素,建立判别方程,为预测老年妇女骨质疏松性髋部骨折提供依据。方法以髋部骨折老年女性患者及保健体检的老年妇女各30例为研究对象,分为观察组和对照组。测量所有样本髋都BMD(病例组为健侧,对照组为左侧)、颈干角(NSA)、左手握拳力;根据身高体重算出BMI;确定个人及家族女性骨折史。通过logistie回归分析及判别分析,进行统计学处理。结果老年妇女骨质疏松性髋部骨折的危险因素为: ward区BMD、NSA、BMI、左手握拳力;老年妇女骨质疏松性髋部骨折的危险性判别方程:Y1=-8．802×X1+88．803×X2+9．936×X3+8．119×X4+2．634×X5+ 22．439×X6-691．647,Y0=-9．901×X1+93．959×X2+15．872×X3+8．045×X4+ 3．037×X5+23．533×X6-696．287;将判别方程进行组内回代检验,特异度为 76．7％,灵敏度为86．7％,预测正确率为81．7％。结论通过判别方程能够预测老年妇女骨质疏松性髋部骨折的危险性。Objective To study the relationship between the osteoporotic hip fracture in elderly women and the risk factors, we establish a equation to predict the probability of the osteoporotic hip fracture in elderly women. Method The women diagnosed as the osteoporotic hip fracture are regarded as the case and the other women for physical examination are regarded as the control. Based on the standards of fit and rejection, 30 cases and 30 controls are introduced to the study. We use the Dual Energy X-ray Absorptiometry(DgX-A) bone densitometry to examine the bone mineral density(BMD) of hip and neck - shaft angle(NSA),measure the left grip strength, then calculate the body mass index(BMI) according the height and weight. Meanwhile, we inquire about the individual history and the family history of osteoporotic fracture. By Logistic regression analysis, the risk factors are screened, the regression coefficients are standardized and the contribution of the risk factors is compared,By discriminant analysis,we establish a equation for prediction. Result The BMD of the ward area, the NSA,the BMI and the left grip strength are the risk factors of the osteoporotic bib fracture in elderly women; The equation to predict the probhbility is: Y1 =-8.802×X1 + 88. 803×X2 + 9.936×X3 + 8.119×X4 + 2.634×X5 + 22.439×X6 -696.647×Y0 = - 9.901×X1 + 93.959×X2 + 15.872×X3 + 8.045×X4 + 3.037×X5 + 23.533×X6-696.287; The specificity is 76.7% , the sensitivity is 86.7% and the rates of prediction correctness is 81.7%. Conclusion We can calculate the probability of the risk of osteoporotic hip fracture inelderly women by discriminant equation.

关 键 词：骨质疏松 髋部骨折 危险性预测 骨密度 股骨近端几何结构判别分析 

分 类 号：R683.2[医药卫生—骨科学]