论文部分内容阅读
目的初步探讨北京老年男性骨质疏松性椎体初发骨折与再发骨折的相关性。方法251例老年男性志愿者,平均年龄72岁±6岁,分别行腰椎、股骨近端骨密度测量及胸腰椎侧位X线平片的随访检查,随访间隔37年±04年。结果本组男性椎体初发骨折患病率28%(95%CI228%～343%);再发骨折率32%(14%～62%)。椎体初发及再发骨折主要分布于T8及T12L1水平。有再发骨折组平均年龄高于随访前后均无骨折组及有初发骨折无再发骨折组(P<005)。有初发骨折无再发骨折组大粗隆、股骨颈平均骨密度低于随访前后均无骨折组(P<005);有再发骨折组Ward′s区平均骨密度低于其他两组。有椎体初发骨折组再发骨折率(70%)高于无初发骨折组再发骨折率17%(P<005)。Logistic回归分析显示年龄、初发骨折程度与再发骨折显著相关,OR=1229(1037～1407)及OR=4270(1.691～10785)。有4个椎体初发骨折组再发骨折构成比333%,趋势上高于其他组。结论北京老年男性骨质疏松性椎体再发骨折与年龄、椎体初发骨折程度密切相关,且独立于骨密度。有椎体初发骨折,椎体再发骨折比例增高,并随着椎体初发骨折数目及程度增加而增高。对有椎体初发骨折的高龄人群应以足够重视,从而减少再发骨折的发生。
Objective To investigate the correlation between primary osteoporotic vertebral fractures and recurrent fractures in elderly men in Beijing. Methods A total of 251 elderly male volunteers with mean age of 72 years and 6 years old were enrolled in this study. The lumbar and proximal femur BMD and the follow-up examination of the thoracolumbar spine were performed respectively. The follow-up interval was 37 years ± 04 years. Results The prevalence of primary vertebral fractures in men was 28% (95% CI228% ~ 343%). The rate of secondary fracture was 32% (14% -62%). Primary and recurrent vertebral fractures are mainly distributed in T8 and T12L1 levels. The mean age of patients with recurrent fracture was higher than that without fracture before and after follow-up and without recurrent fracture with initial fracture (P <005). There was no major fracture in the group with primary fracture, and the average bone mineral density in the femoral neck was lower than that without fracture (P <0.05). The average bone mineral density of Ward’s area with recurrent fracture was lower than that of the other two groups. The rate of recurrent fracture in primary vertebral fracture group was higher than that in primary fracture group (70%) (P <0.05). Logistic regression analysis showed that age, incidence of primary fracture and recurrence fracture were significantly associated with OR = 1229 (1037-1407) and OR = 4270 (1.691-10785). There were 333 cases of recurrent fractures in the 4 primary fractures of the vertebral body, the trend was higher than the other groups. Conclusions The incidence of osteoporotic vertebral recurrence in elderly men in Beijing is closely related to age, degree of primary fracture, and is independent of bone mineral density. There are primary vertebral fractures, vertebral fractures increased the proportion of fractures, and with the initial increase in the number and extent of vertebral fractures increased. The elderly with primary fractures of the vertebral body should pay enough attention to reduce the incidence of recurrent fractures.