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目的探讨社区老年骨质疏松患者跌倒流行特征及危险因素,为骨质疏松防治及预防跌倒提供依据。方法于2014年5月采用多阶段随机整群抽样法,抽取1 289名60岁以上社区居民进行横断面调查,包括问卷询问过去1年跌倒发生情况和跌倒相关危险因素,超声骨密度仪测定跟骨骨密度,以及进行下肢肌力和平衡功能测试。应用Spearman偏相关及logistic回归进行统计分析。结果骨质疏松及非骨质疏松人群过去1年跌倒发生率(分别为17.50%、6.36%)差异有统计学意义(χ2=39.771,P<0.01)。全人群平衡能力[直线行走步态测试(TGT)]及下肢肌力[起立行走测试(TUG)和站起坐下测试(CRT)]高风险率分别为59.35%、63.38%和44.22%,OP组分别为78.53%、88.27%和61.83%,非OP组分别为47.07%、47.46%和32.95%;跌倒发生与平衡能力(TGT)及下肢肌力(TUG和CRT)减弱呈正相关,偏相关系数r值分别为0.13、0.09和0.10(P<0.05)。logistic回归分析发现,平衡能力减弱(TGT<6/8)(OR=1.690,95%CI:1.242~2.300)和罹患骨质疏松(OR=1.573,95%CI:1.142~2.166)为跌倒危险因素。结论骨质疏松通过影响平衡能力增加跌倒风险。针对危险因素开展综合干预可降低跌倒发生。
Objective To investigate the epidemiological characteristics and risk factors of falls in elderly patients with osteoporosis in community in order to provide basis for preventing and treating osteoporosis and preventing falls. Methods A multistage random cluster sampling method was used in May 2014 to survey 1 289 community residents over the age of 60 for cross-sectional survey. The questionnaires were used to inquire about the incidence of falls and risk factors related to falls in the past year. Ultrasound bone mineral density Bone mineral density, and lower limb muscle strength and balance function test. Spearman partial correlation and logistic regression were used for statistical analysis. Results The incidence of falls in the group of osteoporosis and non-osteoporosis in the past year (17.50% and 6.36%, respectively) was statistically significant (χ2 = 39.771, P <0.01). The high risk rates of total population balance [walking gait test (TGT)] and lower extremity muscle strength [standing test (TUG) and standing test (CRT)] were 59.35%, 63.38% and 44.22% (78.53%, 88.27% and 61.83%, respectively) in the non-OP group and 47.07%, 47.46% and 32.95% in the non-OP group, respectively. The incidence of falls was positively correlated with the balance ability (TGT) and lower limb muscle strength (TUG and CRT) r values were 0.13, 0.09 and 0.10, respectively (P <0.05). Logistic regression analysis showed that the risk of falls was decreased with the decrease of balance (TGT <6/8) (OR = 1.690, 95% CI: 1.242-2.300) and osteoporosis (OR = 1.573, 95% CI: 1.142-2.166) . Conclusion Osteoporosis increases the risk of falls by influencing balance. Integrated intervention for risk factors can reduce falls.