老年患者脆性骨折1072例分析  

Fragility fracture in the elderly:a retrospective study of 1 072 patients

作　　者：陈瑾瑜[1] 游利[1] 潘凌[1] 陈琳[1] 王育璠[1] 彭永德[1] 

机构地区：[1]上海交通大学附属第一人民医院内分泌代谢科,上海200080

出　　处：《世界临床药物》2016年第6期385-389,共5页World Clinical Drug

摘　　要：目的探讨老年人群脆性骨折的临床特点及与骨密度(BMD)、骨代谢标记物的关系,为老年人脆性骨折的防治提供依据。方法选取2009年1月至2013年12月在我院骨质疏松门诊初诊的老年脆性骨折患者(年龄≥65岁),记录骨折部位、次数,同时测定患者体质量指数(BMI)、BMD、尿钙/尿肌酐比(u Ca/Cr)、血钙、血磷、骨碱性磷酸酶(BAP)、骨钙素(OC)、I型胶原羧端末肽(β-CTX)和25-羟维生素D[25-(OH)D]等指标。按骨折部位分为椎体骨折组、髋部骨折组及其他部位骨折组,按骨折次数分为单次骨折组和多次骨折组。采用SPSS 19.0软件进行统计学分析。结果共有1 072例患者发生1 241例次脆性骨折,椎体骨折439例次,髋部骨折112例次,其他部位骨折690例次,其中162例患者有多次多部位骨折。所有患者骨量减少检出率达95.0%,其中骨质疏松检出率为55.1%。不同部位骨折各组患者的年龄、BMI、BMD差异均具有统计学意义(P<0.05或P<0.01),而u Ca/Cr、血钙、血磷、OC、β-CTX和25-(OH)D差异均无统计学意义(P>0.05)。单次骨折组和多次骨折组比较,两组年龄和BMD差异均具有统计学意义(P<0.05或P<0.01),而BMI、血钙、血磷、BAP、OC、β-CTX、25-(OH)D和u Ca/Cr组间比较差异无统计学意义(P>0.05)。结论老年人群的脆性骨折与年龄和BMD密切相关,改善BMD有助于减少再次脆性骨折的发生,对高龄患者尤其重要。Objective To investigate the clinical characteristics of senile fragility fracture and its correlation with bone mineral density （BMD） and bone biochemical markers, and to provide data basis for the prophylaxis and treatment of senile fragility fracture. Methods A total of 1 072 senile patients （age≥65 years） with fragility fracture, who were initially consulting in our hospital from January 2009 to December 2013, were selected and divided into three groups [vertebral fractures group（n=439）, hip fractures group（n=112）, other fractures group（n=690）] according to fracture sites or into two groups [single fracture group（n=910） and multiple fractures group（n=162）] according to fracture numbers. The fracture site and numbers, body mass index （BMI）, BMD, uCa/Cr, blood calcium and phosphorus, BAP, osteocalein （OC）, β-CTX and 25-（OH）D were determined. All statistical analyses were performed using SPSS 19.0 software. Results The osteopenia incidence in all patients was up to 95.0%, and the incidence of osteoporosis （OP） was 55.1%. Compared with different site fractures, there was significant difference in age, BMI, and BMD（P〈0.05 or P〈0.01）, and no significant difference in uCa/Cr, OC, β-CTX, blood calcium and phosphorus, and 25-（OH）D （P〉0.05）. The comparison between single fracturegroup and multiple fractures group showed that there was significant difference in age and BMD （P〈0.05 or P〈0.01）, and no significant difference in uCa/Cr, BMI, blood calcium and phosphorus, BAP, OC, β-CTX and 25-（OH）D3 （P〉0.05）. Conclusion Fragility fracture is closely related with the age and BMD in the elderly. The improvement of BMD is essential for reducing the occurrence of re-fracture in elderly patients.

关 键 词：脆性骨折 骨密度(BMD) 骨代谢标记物 老年人 

分 类 号：R683[医药卫生—骨科学] R589.5[医药卫生—外科学]