中老年膝骨关节炎发病的相关因素  

Relevant factors for knee osteoarthritis in middle aged and old population

作　　者：王伟[1] 王坤正[1] 党小谦[1] 柏传毅[1] 李宁华[2] 王春生[1] 时志斌[1] 马树强[1] 

机构地区：[1]西安交通大学第二医院骨科,陕西省西安市710004 [2]卫生部北京医院流行病学研究室,北京市100730

出　　处：《中国临床康复》2006年第44期15-18,共4页Chinese Journal of Clinical Rehabilitation

基　　金：国家十五科技攻关项目(2004-BA702B06)~~

摘　　要：目的:了解西安市城乡中老年人膝骨关节炎的患病率,探讨其发病特点,为预防与治疗膝骨关节炎提供科学依据。方法:于2005-05/10调查西安市城乡部分地区长期居住、具有本地户口、≥40岁的汉族人群。外出未归1年者不列入调查。按照分层、多阶段、整群随机的原则抽取3个居委会和两个村委,共调查1450名。采用统一的调查问卷,内容包括一般情况、现病史、既往史、体格检查等。并安排被调查对象拍双膝正侧位X射线片。根据问卷内容确实有临床症状,且放射学X射线片显示Kellgren&Lawrence分级≥Ⅱ级的,排除继发性骨关节炎后,可以确诊膝原发性骨关节炎。结果:共调查1450名,男704名,女746名。确诊膝骨性关节炎患者176名,城市100名,农村76名。①膝关节骨关节炎患病率12.1%,有骨赘形成19.2%,膝部疼痛48%,膝部摩擦音18.3%。左膝骨关节炎2.1%,右膝2.5%。②女性骨关节炎患病率是男性患病率的2.5倍(分别为17.2%,6.8%,P=0.000);骨赘形成出现率是男性的2.3倍(分别为26.5%,11.4%,P=0.000);膝部症状出现率与男性比较差异无显著性(分别为54.7%,47.4%)。③膝骨关节炎的患病率、骨赘形成出现率随年龄的增长而呈增高趋势。膝部症状出现率也随年龄增长有增高趋势,但在56～60岁及66～70岁年龄段有阶段性回落现象。④城市患者膝骨关节炎患病率较农村稍高,但差异无显著性意义(分别为12.9%,11.2%)。城市患者膝部症状出现率较农村明显升高(分别为56.3%,45.3%,P=0.003)。城市患者膝部骨赘形成出现率与农村患者比较差异无显著性意义(分别为21.4%,16.6%)。⑤膝骨关节炎患病率和骨赘形成出现率在职业分布中差异无显著性意义(分别为重体力劳动11.6%,非重体力劳动14.4%;重体力劳动18.4%,非重体力劳动22.3%)。非重体力劳动者膝部症状出现率明显高于重体力劳动者,差异有显著性意义(分别为62.6%,48.5%,P=0.003)。�AIM： To explore the prevalence and pathogenetic features of knee osteoarthritis among the middle-aged and elderly people in the urban and rural of Xi ＇an, so as to provide some available evidence for precaution and treatment of osteoarthritis of the knee. METHODS： From May to October 2005, those aged above 40 years, had been living in Xi＇an for a long time were investigated except someone had been gone out for more than 1 year. 1 450 people from 8 communities and 5 counties were involved according to multiple stage cluster sampling. The unified questionnaire, including general state of health, present history, past history, physical examination etc, was carried out and all subjects were given both knees nonnotopia and lateral position radiographic examination. Excluded other etiological factors, some of them were finally diagnosed as idiopathic osteoarthritis of knee if they had clinical symptoms and a radiographic grade above Kellgren ＆ Lawrence Ⅱ grade. RESULTS： Among the 1 450 persons involved in the result analysis, there were 704 men and 746 women. 176 persons including 100 urban and 76 rural ones were diagnosed as idiopathic osteoarthritis of knee. （1）The total prevalence of idiopathic osteoarthritis of knee was 12.1%, radiographic osteophyte of knee was 19.2%, friction sound of knee was 18.3%, right and left keens were 2.5% and 2.1% respectively.（2）The prevalence of knee osteoarthritis of women was 2.5 times of that of the men （17.2%,6.8%,P=0.000）; the prevalence of radiographic osteophyte of women was 2.3 times of that of the men （26.5%, 11.4%, P=0.000）; There was no significant difference in the prevalence of symptomatic knee between women and men （54.7%, 47.4%）. （3）The prevalence of knee osteoarthritis and osteophyte increased with the augment of age, so was the symptomatic knee, except the stages of 56-60 years and 66-70 years. （4）The prevalence of knee osteoarthritis of urban was higher slightly than that of rural patients, which had no significant differenc

关 键 词：骨关节炎 膝 膝关节 流行病学 

分 类 号：R684.3[医药卫生—骨科学]