血清25羟维生素D水平与脆性髋部骨折关系的研究  

Prognostic Value of Abnormal Serum Rena Study of the relationship between serum 25-hydroxyl vitamin D level and fragile hip fractures

作　　者：许昊[1] 李毅中[1] 庄华烽[1] 王培文[1] 林金矿[1] 姚学东[1] 俞海明[1] XU Hao;LI Yizhong;ZHUANG Huafeng;WANG Peiwen;LIN Jinkuang;YAO Xuedong;YU Haiming(Department of Orthopedics,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院,福建泉州362000

出　　处：《中国骨质疏松杂志》2020年第3期340-344,共5页Chinese Journal of Osteoporosis

摘　　要：目的研究血清羟维生素D水平与脆性髋部骨折之间的关系。方法对2013年1月至2015年12月入住我院的年龄≥50岁,且进行血清25羟维生素D(25 hydroxy vitamin D,25OHD)检测的181例女性脆性髋部骨折患者的临床资料进行回顾性分析。统计患者的年龄、骨折部位、血清25OHD水平、骨密度(bone mineral density,BMD)水平,及术后随访1年及以上的67例患者的预后情况。观察血清25OHD水平与上述指标之间的关系。结果181例≥50岁的女性脆性髋部骨折患者中维生素D缺乏127例(70.2%),不足42例(23.2%),充足12例(6.6%)。年龄≤75岁组患者血清25OHD水平显著高于年龄>75岁组,血清25OHD≥20 ng/m L患者组骨密度水平均显著高于25OHD<20 ng/m L组,股骨颈骨折患者血清25OHD水平高于股骨转子间骨折患者,差异无统计学意义,随访患者中血清25OHD≥20 ng/m L患者组1年内再跌倒率、再骨折率及全因死亡率低于25OHD<20 ng/m L组,差异无统计学意义,前者术后户外行动能力显著高于后者。结论维生素D缺乏及不足在老年女性脆性髋部骨折患者普遍存在,血清25OHD水平与患者的年龄、骨密度及预后存在相关性。Objective To investigate the correlation between serum hydroxyl vitamin D level and fragile hip fractures.Methods The clinical data of 181 female fragile hip fracture patients(age≥50 years),who were admitted to our hospital from January 2013 to December 2015 and undergone serum 25-hydroxyl vitamin D(25 OHD)test,were analyzed retrospectively.The age,fracture site,serum 25 OHD level and bone mineral density(BMD)of the patients,as well as the outcome of 67 patients followed up for at least one year,were recorded.The correlation between serum 25 OHD level and these indices was observed.Results In 181 over50 years old female patients with fragile hip fractures,there were 127 cases(70.2%)with vitamin D deficiency,42 cases(23.2%)with vitamin D insufficiency,and 12 cases(6.6%)sufficient vitamin D.The serum 25 OHD level in patients who were less than 75 years was markedly higher than that in patients over 75 years old.BMD level in patients with 25 OHD over 20 ng/mL was higher than in patients with 25 OHD less than 20 ng/mL.The serum 25 OHD level in patients with femoral neck fractures was higher than in patients with inter-trochanter fractures,but the difference was not statistically significant.Among patients followed up within one year,the patients with 25 OHD over 20 ng/mL had lower fall rate,fracture rate,and all-cause mortality than those with25 OHD less than 20 ng/mL,but the difference was not statistically significant.The outdoor action ability in patients with 25 OHD over 20 ng/mL was markedly higher than that in patients with 25 OHD less than 20 ng/mL.Conclusion Vitamin D deficiency and insufficiency are prevalent in elderly female patients with fragile hip fractures.Serum 25 OHD level is correlated with age,BMD,and the outcome of the patients.

关 键 词：血清25OHD 骨密度 脆性髋部骨折 预后 

分 类 号：R683.42[医药卫生—骨科学]