成人大骨节病患者肢体残疾病情调查  

Investigation of physical disability in adults patients with Kashin-Beck disease

作　　者：刘宇蛟 李春辉 李佳鑫 张鑫 吴宪昊 刘宁[1] 曹艳红[1] 邓晴[1] 刘运起[1] 于钧[1] Liu Yujiao;Li Chunhui;Li Jiaxin;Zhang Xin;Wu Xianhao;Liu Ning;Cao Yanhong;Deng Qing;Liu Yunqi;Yu Jun(Institute for Kashin-Beck Disease Control and Prevention,Center for Endemic Disease Control,Chinese Center for Disease Control and Prevention,Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心大骨节病防治研究所,150081

出　　处：《中华地方病学杂志》2020年第11期810-814,共5页Chinese Journal of Endemiology

基　　金：国家自然科学基金(81872564);黑龙江省应用技术研究与开发计划重大项目(GA18C007)。

摘　　要：目的了解成人大骨节病患者肢体功能障碍程度,以及大骨节病临床分度与肢体残疾分级的相关性。方法根据监测数据采用典型调查方法,2015年在黑龙江省大骨节病历史重病区选取10个自然村为调查点。以年龄≥40岁的大骨节病患者作为调查对象,进行问卷调查、关节活动度(ROM)测量以及X线片拍摄。依据《残疾人残疾分类和分级》(GB/T26341-2010)国家标准对调查对象肢体残疾程度予以评价,并对大骨节病临床分度与肢体残疾分级进行相关分析。结果共调查137例成人大骨节病患者,年龄为(57.4±9.9)岁;其中男性84例,女性53例;Ⅰ度95例,Ⅱ度30例,Ⅲ度12例。患者关节疼痛上肢以指间关节最为多见(126例,126/137),其次是肘关节(116例,116/137);下肢则以踝关节(118例,118/137)、膝关节为主(107例,107/137)。肘关节伸、膝关节屈和伸、踝关节背屈和跖屈、髋关节和腕关节掌伸活动的功能障碍检出率在各年龄组间比较差异有统计学意义(P均<0.05),随患者年龄增长而升高。大骨节病临床分度与肢体残疾分级不相关(rs=-0.142,P>0.05)。大骨节病患者以三级肢体残疾所占比例最高(60例,60/137)。男性较女性患者肢体残疾严重(χ^2=22.610,P<0.01)。结论成人大骨节病患者关节疼痛上肢以指间关节疼痛最为多见,下肢以踝关节、膝关节为主。临床分度与肢体残疾分级水平间未见关联性,男性患者肢体残疾程度较女性患者重。Objective To investigate the degree of limb dysfunction in adult patients with Kashin-Beck disease(KBD),and the correlation between clinical grade of KBD and physical disability classification.Methods Based on the monitoring data,using typical survey methods,10 natural villages were selected as survey sites in the historical critical area of KBD in Heilongjiang Province in 2015.Patients over 40 years old with KBD were investigated by questionnaire,joint range of motion(ROM)examination,and X-ray film were performed.The degree of physical disability of the surveyed patients was evaluated according to the national standard of"Classification and Grading of Disability of the Disabled"(GB/T 26341-2010).The correlation between clinical classification of KBD and limb disability classification was analyzed.Results A total of 137 adult patients with KBD were investigated,the age was(57.4±9.9)years old.Among them,84 were males and 53 were females;95 were grade Ⅰ,30 were grade Ⅱ and 12 were grade Ⅲ.The most common joint pain of upper limb was interphalangeal joint(126 cases,126/137),followed by elbow joint(116 cases,116/137);the lower limbs were mainly ankle joint(118 cases,118/137)and knee joint(107 cases,107/137).There were significant differences of detection rates in elbow,knee,ankle,hip and wrist joints dysfunction among different age groups(P<0.05).The detection rate increased with age.There was no correlation between the clinical grade of KBD and the classification of physical disability(rs=-0.142,P>0.05).KBD patients accounted for the highest proportion of tertiary disability(60 cases,60/137).The physical disability of male patients was more serious than that of female patients(χ^2=22.610,P<0.01).Conclusions In adults with KBD,interphalangeal joint pain is the most common in the upper limbs,and the ankle and knee joints are the most common in the lower limbs.There is no correlation between clinical grade of KBD and the level of physical disability.The degree of physical disability in male patients is higher t

关 键 词：大骨节病 临床分度 关节功能障碍 残疾鉴定 

分 类 号：R684.1[医药卫生—骨科学]