原发性膝关节骨关节炎严重程度的危险因素分析  

Risk factors influencing the severity of primary knee osteoarthritis:a correlation study

作　　者：张烽 王斌[2] 曹蔼萱 唐瑭 Zhang Feng;Wang Bin;Cao Aixuan;Tang Tang(School of Public Health,North China University of Science and Technology,Tangshan 063000,China;The Second Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]华北理工大学公共卫生学院,唐山063000 [2]唐山市第二医院,唐山063000

出　　处：《中华创伤骨科杂志》2024年第8期698-704,共7页Chinese Journal of Orthopaedic Trauma

摘　　要：目的分析原发性膝关节骨关节炎(KOA)严重程度的危险因素。方法回顾性分析2015年1月至2022年12月唐山市第二医院治疗的4057例原发性KOA患者资料。将患者根据Kellgren-Lawrence分级分为轻型(Kellgren-Lawrence分级Ⅱ级)组、中型(Kellgren-Lawrence分级Ⅲ级)组及重型(Kellgren-Lawrence分级Ⅳ级)组。纳入3组患者的基础资料和入院3 d以内的实验室指标进行单因素分析,通过logistic回归分析筛选出原发性KOA的危险因素。结果单因素分析结果显示,年龄、原发性高血压、冠状动脉粥样硬化性心脏病、糖尿病、吸烟、血型、红细胞沉降率(ESR)、补体C3、IgM、类风湿因子(RF)、总蛋白、C-反应蛋白(CRP)3组间比较差异均有统计学意义(P<0.05)。logistic回归分析结果表明,年龄以40~49岁为参照,50~59岁、60~69岁、≥70岁年龄组与原发性KOA严重程度存在正向关联(OR=1.866,95%CI:1.379~2.527;OR=4.259,95%CI:3.168~5.726;OR=7.486,95%CI:5.403~10.360);原发性高血压、AB血型、IgM水平异常及ESR、RF、CRP水平的升高与原发性KOA严重程度均存在正向关联(OR=1.550,95%CI:1.366~1.756;OR=1.265,95%CI:1.103~1.451;OR=1.385,95%CI:1.217~1.579;OR=1.385,95%CI:1.217~1.579;OR=1.252,95%CI:1.026~1.528;OR=1.276,95%CI:1.013~1.608)。结论年龄增长、患原发性高血压、AB血型、IgM水平异常、ESR水平升高、RF水平升高、CRP水平升高均为原发性KOA严重程度的危险因素。ObjectiveTo analyze the risk factors for the severity of primary knee osteoarthritis(KOA).MethodsA retrospective study was conducted to analyze the 4,057 patients with primary KOA who had been treated at The Second Hospital of Tangshan from January 2015 to December 2022.The patients were divided into 3 groups based on their Kellgren Lawrence classification:a mild group(Kellgren Lawrence grade II),a moderate group(Kellgren Lawrence grade III),and a severe group(Kellgren Lawrence grade IV).Univariate analysis was conducted of the basic data and laboratory indicators within 3 days after admission of the 3 groups of patients.Multivariate logistic regression analysis was conducted to identify the risk factors for primary KOA.ResultsThe univariate analysis showed that there were significant differences among the 3 groups in age,primary hypertension,coronary atherosclerotic heart disease,diabetes,smoking,blood type,erythrocyte sedimentation rate(ESR),complement C3,IgM,rheumatoid factor(RF),total protein,and C-reactive protein(CRP)(P<0.05).The multivariate logistic regression analysis showed that there was a positive correlation between the severity of primary KOA and the age groups of 50 to 59 years old,60 to 69 years old,and≥70 years old,with a reference age of 40 to 49 years old(OR=1.866,95%CI:1.379 to 2.527;OR=4.259,95%CI:3.168 to 5.726;OR=7.486,95%CI:5.403 to 10.360)and that there was a positive correlation between primary hypertension,AB blood type,abnormal IgM levels,and elevated levels of ESR,RF,and CRP with the severity of primary KOA(OR=1.550,95%CI:1.366 to 1.756;OR=1.265,95%CI:1.103 to 1.451;OR=1.385,95%CI:1.217 to 1.579;OR=1.385,95%CI:1.217 to 1.579;OR=1.252,95%CI:1.026 to 1.528;OR=1.276,95%CI:1.013 to 1.608).ConclusionsAging,primary hypertension,AB blood type,abnormal IgM levels,elevated ESR levels,elevated RF levels,and elevated CRP levels are all risk factors for the severity of primary KOA.

关 键 词：膝关节 骨关节炎 疾病严重程度指数 回归分析 

分 类 号：R684.3[医药卫生—骨科学]