跌倒和髋部骨密度对绝经后妇女骨折风险的影响  

Effect of falls and BMD of hip on fracture risk

作　　者：范璐[1] 林华[1] 陈新[1] 朱秀芬[1] 钱程[1] 黄淑纾[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨病中心,南京210008

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2011年第4期241-246,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：江苏省社会发展基金项目(BE2011605)

摘　　要：目的探讨跌倒和骨密度对绝经后妇女骨折发生率的影响。方法对2008年9月至2010年12月在南京市鼓楼医院骨质疏松症专病门诊体检、年龄为45～85岁的500名绝经后妇女的临床资料进行回顾性分析。收集受试者年龄、身高、体重、既往病史、跌倒史和骨折史,并进行跌倒指数和骨密度评估。结果 500名绝经后妇女的平均年龄为(65.9±8.2)岁,全髋和股骨颈骨密度T值均值分别为-1.58±1.16和-1.78±1.06。其中159例(31.8%)有跌倒史,222例(44.4%)有骨折史(非暴力性骨折)。Logistic回归分析结果显示,跌倒史对骨折发生率的影响最为显著(OR=5.070),年龄与骨折发生率呈正相关(OR=1.038),身高与骨折发生率呈负相关(OR=0.956)。体重、全髋及股骨颈骨密度T值对骨折发生率无明显影响。结论预防骨质疏松性骨折不能仅单纯提高骨密度和增加骨量,预防跌倒和全面提高骨质量需引起临床医师的注意。Objective To study the effect of falls and bone mineral density （BMD） on the fracture risk of postmenopausal female. Methods We carried out a retrospective study comprising 500 postmenopausal women aged 45 to 85 years old. The information of previous falls and fracture was obtained, and meanwhile, Fall Index and BMD were assessed for each participant. Results The mean age of participants was 65.9 ± 8.2 years old. The mean T score of total hip and femur BMD were - 1.58 ± 1.16 and - 1.78 ± 1.06, respectively. There were 31.8% patients reported a history of falls while 44.4% had a previous osteoporotic fracture. The logistic regression analysis confirmed an inverse effect of falls his- tory （ OR =5. 070） and increasing age （ OR = 1. 038） on higher fracture incidence. In contrast, individuals who were tal- ler had a lower risk of fracture （ OR = - 0. 956 ）. There was no significant difference between total hip or femur BMD and fracture incidence. Conclusion This study has demonstrated that fall is the main cause of fracture in postmenopausal women while lower BMD is an embedded risk factor. For the prevention of fracture, more attention should he paid in the reduction of the incidence of falls rather than in concerning about increasing BMD level only.

关 键 词：骨折 跌倒 骨密度 

分 类 号：R681[医药卫生—骨科学]