摘要
目的:腰椎骨关节炎所致疼痛和关节活动受限等,严重影响中老年患者的生活质量。了解中老年人群腰椎骨关节炎患病危险因素、患病率及疾病与暴露因素之间联系强度的指标,可为腰椎骨关节炎的社区预防干预提供量化性参考数据。方法:调查于2005-07/08在西安、石家庄、上海、广州、哈尔滨、成都等六城市完成。①调查对象:选择40岁及以上具有正式户口常住男女人群6218名,其中男2916名,年龄40～94岁;女3302名,年龄40～86岁;男女性别比为0.88∶1.00。纳入标准:中国汉族在本地具有正式户口的居民并对本次调查知情同意。排除标准:因各种原因外出超过1年以上居民不属本次调查对象。②调查方法:采用分层多阶段整群抽样方法对中国六城市(西安、石家庄、上海、广州、哈尔滨、成都)6218名符合调查对象人群进行腰椎骨关节炎的流行病学问卷调查(调查内容包括一般情况、现病史、既往史、体格检查、X射线片检查情况、疾病诊断),并对其中4808例有症状者进行X射线片腰椎正侧位投照,对83个变量进行多因素非条件Logistic回归分析。表示疾病与暴露因素之间联系强度的指标用比值比(OR),若OR>1,说明疾病发生危险性增加,与暴露因素呈正关联;若OR<1,说明疾病发生危险性减少,与暴露因素呈负关联。结果:纳入调查对象6218名,全部进入结果分析。①中国六城市40岁及以上男女人群腰椎骨关节炎总患病率为29.4%,各城市患病率差异有非常显著性意义(P<0.01)。②腰椎骨关节炎在大部分城市有共同的危险因素如年龄因素(OR=1.031～1.121),使用蹲位排便(OR=1.012-1.044)和共同保护性因素如饮酒(OR=0.241～0.930);而日常骑摩托(OR=3.122,西安),专职体育(OR=6.377,石家庄),骨质疏松史(OR=5.925,石家庄),神经关节病史(OR=5.528,上海),日常乘公共汽车(OR=5.784,广州),动脉粥样硬化史(OR=4.797,广州),糖尿病史(OR=4.064,广州),日常爬楼梯(坡)(OR=1.018,哈尔滨),兄弟骨关节炎史(OR=11.791,成都)等危险因素分别在不同地区出现;而常吃水果(OR=0.725,西安),喝啤酒(OR=0.507,石家庄)等保护性因素也分别在不同城市出现。结论:中国六个地区腰椎骨关节炎患病有共同的危险因素和保护性因素,同时,不同地区主要危险因素又有一定差异。
AIM： The limitation of joint activity and pains caused by lumbar osteoarthritis seriously affect the life quality of the middle-aged and elderly patients. In this study, the index of association intensity about risk factors, lumbar osteoarthritis prevalence, and exposures factors in the middle-aged and elderly patients was investigated, so as to provide reference data for the prevention and interference of lumbar osteoarthritis in community.
METHODS： The survey was carried out in six cities including Xi＇an, Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu from July to August 2005. ①6 218 people aged above 40 years were selected including 2 916 males aged from 40 to 94 years old and 3 302 females aged from 40 to 86 years old. The ratio of male to female was 0.88 to 1.00. The subjects of Han nationality with formal registered residence in administrative areas and the informed consents were included. The persons went outside more than one year were excluded. ②Epidemiological questionnaire was carried out in 6 218 subjects from the six cities by the stratified-multi-steps-cluster sampling method. The contents of questionnaire were as follows： general information, history and present of diseases, physical examination, X-ray and diagnosis. X-ray in lumbar positive and lateral sides was performed for 4 808 people and 83 variables were analyzed by the non-conditional logistic regression. The index of association intensity between lumbar osteoarthritis and exposure factors was represented by odds ratio （OR）. If OR 〉 1, the risk of disease was increased and positively associated with exposure factors; if OR 〈 1, the risk of disease was decrease and negatively associated with exposure factors. RESULTS： 6 218 subjects were all involved in the result, analysis. ①The total lumbar osteoarthritis prevalence was 29.4% in the population aged above 40 years in those six cities, and the variance of lumbar osteoarthritis prevalence among six cities was very statistically significant （P 〈 0.01）. ②The most common risk factors for lumbar osteoarthritis in six cities involved age （OR =1.031-1.121）, defecation by squatting position （OR =1.012-1.044） and the most common protective factors such as drinking （OR = 0.241-0.930）; otherwise, motorbike （OR =3.122, Xi＇an）, sport worker （OR = 6.377, Shijiazhuang）, history of osteoporosis （OR =5.925, Shijiazhuang）, history of neural osteoarthritis （OR = 5.528, Shanghai）, bus taking （OR =5.784, Guangzhou）, history of atherosclerosis （OR =4.797, Guangzhou）, history of diabetes （OR =4.064, Guangzhou）, stair （slope） climbing （OR =1.018, Harbin）, history of osteoarthritis in brother （OR =11.791, Chengdu） were risk factors in different cities; to take fruits （OR =0.725, Xi＇an） and to drink beer （OR =0.507, Shijiazhuang） as the protective factors of lumbar osteoarthritis were exposed in different cities.
CONCLUSION： Some common risk and protective factors of lumbar osteoarthritis exist in six cities of China. However, there are some special risk factors in different cities.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第47期9508-9512,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
国家"十五"科技攻关计划资助项目(2004BA702B06)~~
