广西1951例股骨头坏死的流行病学研究  

Epidemiological study on 1951 cases of femoral head necrosis in Guangxi

作　　者：覃文涛 赵良军[1] 胡阳[1] 许放 薄占东[1] Qin Wentao;Zhao Liangjun;Hu Yang;Xu Fang;Bo Zhandong(Department of Orthopaedics, the 1th Hospital Affiliated to Guangxi Medical University, Nanning 530021, China)

机构地区：[1]广西医科大学第一附属医院,南宁530021

出　　处：《中华关节外科杂志（电子版）》2021年第3期261-266,共6页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：广西自然科学基金(2017GXNSFAA198352)。

摘　　要：目的对1951例股骨头坏死(ONFH)患者进行流行病学调查和研究,旨在了解其患病情况和地域性特征,并为临床科学防治提供依据。方法通过收集广西医科大学第一附属医院、广西区人民医院和广西骨伤医院三个大型三甲医院2013年1月1日至2019年12月1日被诊断为股骨头坏死的住院患者病例资料,分析其流行病学特点,所选患者的纳入标准为具有完整的MRI、CT和病理学检查等结果,而排除外伤、酒精、激素和特发之外引起的股骨头坏死患者。重点分析性别和民族差异、年龄构成和病因学情况,并对特发性股骨头坏死患者进行单因素和多因素logistic回归分析。结果收集到了病例完整的1951例股骨头坏死患者信息(2757髋),男性1586例,女性365例,男女比为4.35∶1。年龄18~87岁,平均诊断年龄为(51±13)岁。汉族与少数民族比值为1∶2.12,汉族626例,少数民族1325例。壮族在少数民族中最多(772例),其中酒精性和特发性在少数民族人群中患病率最高。患者初诊时FicatⅠ期占0.83%,Ⅱ期占20.96%,Ⅲ期占44.61%,Ⅳ期占33.59%。病因构成中酒精性最多,893例占45.78%,特发性693例,激素性224例,创伤性141例。特发性ONFH危险因素分析中正常组与特发组的甘油三酯(TG)[优势比(OR)=2.41,95%置信区间(CI)(1.37,3.03),P=0.03]和血尿酸(UA)[OR=1.06,95%CI(1.00,1.21),P=0.04]差异具有统计学意义。结论广西不同类型股骨头坏死患病诱因各具特征,性别、年龄、民族和病因之间有相互联系;广西股骨头坏死的病因分析可以起到及时预防和治疗该地区股骨头坏死的作用。Objective An epidemiological survey and study were conducted on 1951 patients with osteonecrosis of the femoral head(ONFH)in order to understand its prevalence and regional characteristics and provide the basis for clinical scientific prevention and treatment.Methods Through collecting the case data of hospitalized patients diagnosed with femoral head necrosis from January 1st,2013 to December 1st,2019 in the First Affiliated Hospital of Guangxi Medical University,Guangxi District People′s Hospital and Guangxi Orthopedics and Traumatology Hospital,and analyzing their epidemiological characteristics,the inclusion criteria of the selected patients were as follows:the patients had complete MRI,CT and pathological examination results,and the patients with femoral head necrosis caused by trauma,alcohol,hormone and idiopathic were excluded.The study focused on the analysis of gender and ethnic differences,age composition and etiology,and univariate and multivariate logistic regression analysis were conducted on the patients with idiopathic femoral head necrosis.Results A total of 1951 cases(2757 hips)of femoral head necrosis were collected,including 1586 males and 365 females,with the ratio of male to female being 4.35∶1.The patients were from 18 to 87 years old,and the average diagnostic age was(51±13)years.The ratio of Han nationality to ethnic minorities was 1∶2.12,including 626 cases of Han nationality and 1325 cases of ethnic minorities.The Zhuang nationality has 772 cases at most among the ethnic minorities,and the prevalence of alcohol and idiopathic diseases was the highest among the ethnic minorities.Among the primary diagnoses,the percentages of FicatⅠwas 0.83%,FicatⅡwas 20.96%,FicatⅢwas 44.61%and FicatⅣwas 33.59%.The etiological constitution of alcoholism was the largest part,with 893 cases(45.78%),while athers were 693 cases idiopathic,224 hormonal cases,and 141 traumatic cases.In the analysis of risk factors for idiopathic ONFH,the differences of TG[odds ratio(OR),OR=2.41,Confidence interval

关 键 词：股骨头坏死 流行病学 

分 类 号：R68[医药卫生—骨科学]