文山地区壮族中老年人群骨质疏松患病率及相关影响因素的研究

发布时间：2018-04-01 21:33

本文选题：文山州壮族　切入点：骨质疏松症　出处：《昆明医科大学》2015年硕士论文

【摘要】：目的：1.采用双能X线吸收测定法对云南省文山地区壮族中老年人群进行骨密度测定,结合其生活方式,探讨文山地区壮族中老年人群骨质疏松症的发病率。2.结合云南省文山地区壮族中老年人群个人基本体征、生活环境和日常生活习惯,探讨文山地区壮族中老年人群骨质疏松症发病的相关危险因素,为云南省文山地区壮族中老年人群骨质疏松症的预防和诊断提供参考依据。3.测定云南省文山地区壮族中老年人群骨质疏松症血清骨代谢标志物,了解其变化规律,预测骨质疏松性骨折的发生情况。方法：采用现代流行病学分层随机抽样法,抽取文山州广南县坝美镇经济条件好、中、差的村委会各一个,随机抽取年龄≥40岁的壮族人群124例,以10岁为一个年龄组进行分组,对受试者进行骨密度测定、基本体征测量、骨质疏松相关影响因素问卷调查,并选取其中一部分受试者72例进行血清VDR、BGP、NTX、CTX的测定。所得数据进行统计学分析。结果：1.文山州壮族中老年人骨质疏松总患病率为8.1%,其中男性患病率为6.0%,女性患病率为9.5%,女性高于男性,但差异无统计学意义。男、女性骨质疏松患病率总体随着年龄的增长呈上升趋势,男性、女性不同年龄组患病率比较无统计学意义,各年龄组男性与女性骨质疏松患病率比较均无统计学意义。2.文山州壮族男、女性骨密度T值总体随着年龄的增长呈下降趋势,男性60-69和70-79岁年龄组和其他年龄组比较差异均有统计学差异(P0.05),女性40-49岁年龄组和其他年龄组比较差异有统计学差异(P0.05)。各年龄组女性骨密度T值均比男性低,60-69和70-79岁年龄组女性骨密度T值和男性比较差异具有统计学意义。3.文山州壮族中老年人群年龄和男、女性骨密度T值有负相关关系(r=-0.551,P0.01;r=-0.607,P0.01),高血压和男、女性骨密度T值有负相关关系(r:-O.387,P0.01:r:-0.234,P0.05),文化程度和男、女性骨密度T值有正相关关系(r:0.411,P0.01:r=0.327,P0.01),腰围和男、女性骨密度T值有正相关关系(r=0.294,P0.05:r=0.253,P0.05),臀围和男、女性骨密度T值有正相关关系(r=0.383,P0.01),饮食豆制品、饮酒和男性骨密度T值有正相关关系(r:0.438,P0.01；r:0.324,P0.05),喝茶和男性骨密度T值有负相关关系(r=0.363,P0.01),体重、体重指数、0STA指数和女性骨密度T值有正相关关系(r:0.656,P0.01:r=0.609,P0.01；r--0.611,P0.01),素食、服用激素、孕次、产次和女性骨密度T值有负相关关系(r=-0.270,P0.05；r=-0.378,P0.01；r=-0.365,P0.01；r=-0.393,P 0.01).男女性骨质疏松患者平均0STA指数为-2.279±3.9704。4.文山州壮族中老年人VDR水平总体随年龄的增长呈上升趋势,总体波动在35.05±20.74-48.74±22.69pg/ml之间。男性BGP水平最高出现在50～59岁年龄段,为1.86±1.52ng/ml,女性BGP水平最高在40～49岁年龄段,为1.34±1.08ng/ml,其后缓慢下降。NTX.CTX水平均随年龄增长呈缓慢上升趋势,NTX总体波动在0.43±O.26～0.67±0.23nmBCE／L,CTX总体波动在0.24±0.89～ 0.35±0.13ug/L.VDR、BGP、NTX、CTX与年龄、骨质疏松相关性均无统计学意义。结论：1.文山州壮族中老年人骨质疏松患病率总体低于同类报道水平,女性患病率高于男性。2.文山州壮族中老年人骨密度T值总体随年龄的增长呈下降趋势,骨质疏松患病率总体随年龄的增长呈上升趋势。男性60岁以后骨密度T值明显下降,而女性则为50岁以后,原因主要与女性绝经后雌激素下降密切相关。3.高年龄、高血压、骨质疏松知识匮乏是文山州壮族中老年人骨质疏松的共同危险因素,男性骨质疏松的危险因素还有喝茶,女性骨质疏松的危险因素还有素食、服用激素、多孕次、多产次；适当的腰围、臀围是文山州壮族中老年人骨质疏松的共同保护因素,男性骨质疏松的保护因素还有食用豆制品、适当饮酒,女性骨质疏松的保护因素还有适当的体重、体重指数。4.文山州壮族中老年人OSTA指数低于-2.3时,应高度警惕骨质疏松。5.文山州壮族中老年人VDR水平总体随年龄的增长呈上升趋势,男性60岁以前骨形成持续加强,其后缓慢下降,女性50岁以前骨形成持续加强,其后缓慢下降,40岁以后,男女性骨吸收持续加强,但总体处于低骨转换状态。其骨代谢标志物水平可反映骨密度T值的基本情况。6.搞好文山州壮族群众骨质疏松防治工作,应加强相关知识的基层宣传工作,根据相关的骨质疏松危险和保护因素采取综合干预措施,控制可控危险因素,加强保护因素,动态监测骨转换标志,给予相应抗骨质疏松治疗,降低和延缓当地中老年壮族群众骨质疏松和骨质疏松性骨折的发生。
[Abstract]:Objective: 1. using dual energy X-ray absorptiometry bone mineral density in the elderly population of Zhuang Nationality in Wenshan city in Yunnan Province, with its way of life, to explore the osteoporosis of aged people in Wenshan Zhuang in the incidence rate of.2. combined with the Zhuang Nationality in Wenshan area of Yunnan province in the elderly people the basic signs, living environment and daily life habits. To explore the risk area of Wenshan Zhuang in the elderly osteoporosis factors, to provide reference for the determination of.3. in Yunnan Province, the mountain area Zhuang osteoporosis in middle-aged and elderly people in serum bone metabolic markers for the diagnosis and prevention of elderly population of Zhuang Nationality in Wenshan area of Yunnan Province in osteoporosis, understand the change rule, to predict the occurrence of osteoporosis fracture. Methods: using modern epidemiology stratified random sampling method from Wenshan Guangnan County town of the United States and good economic conditions, poor. The village of each one, randomly selected from 40 years of age or older in Zhuang population in 124 cases, with 10 years as one age group were divided into two groups of subjects to determine the bone density, physical measurement, survey influence osteoporosis factor questionnaire, and selected a part of 72 subjects in serum VDR BGP, NTX, CTX were measured. The data were statistically analyzed. Results: 1. Wenshan Zhuang in the elderly osteoporosis total prevalence rate was 8.1%, the prevalence rate of male was 6%, female prevalence rate was 9.5%, female is higher than male, but the difference was not statistically significant. The male female, the prevalence rate of osteoporosis with overall age increased, men and women of different age groups prevalence rate had no significant difference between male and female in each age group, the prevalence rate of osteoporosis was no significant difference of.2. in Wenshan Zhuang nationality male, female bone mineral density T value with the whole year Age decreased, there were statistically significant differences between men 60-69 and 70-79 age group and other age groups (P0.05), there were significant differences between the female 40-49 year old age group and other age groups (P0.05). Each age group of women bone density T values were lower than men, 60-69 and 70-79 year old age group the BMD of female T and male were statistically significant in elderly age and male.3. of Wenshan Zhuang, BMD T value had negative correlation (r=-0.551, P0.01; r=-0.607, P0.01), hypertension and male, female bone mineral density T value had negative correlation (r:-O.387, P0.01:r:-0.234, P0.05), culture the degree of male and female bone density, T value had positive correlation (r:0.411, P0.01:r=0.327, P0.01), waist circumference and male, female bone mineral density T value had positive correlation (r=0.294, P0.05:r=0.253, P0.05), hip circumference and male, female bone mineral density T value had positive correlation (r= 0.383, P0.01), soy products, alcohol and bone mineral density in male T value had positive correlation (r:0.438, P0.01; r:0.324, P0.05), tea and bone mineral density in male T value has negative correlation (r=0.363, P0.01), body weight, body mass index, 0STA index and BMD T value had positive correlation (r:0.656, P0.01:r=0.609, P0.01; r--0.611, P0.01), vegetarian, steroid, gravidity, parity and BMD T value had negative correlation (r=-0.270, P0.05; r=-0.378, P0.01; r=-0.365, P0.01; r=-0.393, P 0.01). Male and female osteoporosis patients with the average 0STA index for the overall level of VDR in elderly patients -2.279 + 3.9704.4. in Wenshan Zhuang increased with age, the overall volatility between 35.05 + 20.74-48.74 + 22.69pg/ml. The highest BGP level in men 50~59 years of age, 1.86 + 1.52ng/ml, BGP level was highest in women 40~49 years of age, 1.34 + 1.08ng/m L, then a slow decline in the level of.NTX.CTX were increased with age increased slowly, the overall volatility in NTX 0.43 + O.26 ~ 0.67 + 0.23nmBCE / L, CTX overall fluctuations in 0.24 + 0.89 ~ 0.35 + 0.13ug/L.VDR, BGP, NTX, CTX and age, patients with osteoporosis were not statistically significant. Conclusion: 1. Wenshan Zhuang the elderly osteoporosis prevalence is lower than the overall level of similar reports, the prevalence of female is higher than that of T bone density in the elderly male.2. Wenshan Zhuang value decreased with the increase of age, the prevalence rate of osteoporosis increased with age increased. 60 men after the age of bone mineral density T value decreased, and the female is 50 years old, and the main cause of postmenopausal women estrogen is closely related to the decrease of.3. high age, hypertension, osteoporosis, lack of knowledge is a common risk state of Wenshan Zhuang osteoporosis of the elderly male factors, bone The risk factors of osteoporosis and osteoporotic women drink tea, the risk factors are vegetarian, taking hormones, number of pregnancies, productive times; appropriate waist circumference, hip circumference is to protect the state of Wenshan Zhuang osteoporosis of the elderly, the protective factors for male osteoporosis and eating soy products, moderate alcohol consumption, women with protective factors loose and proper weight, body mass index.4. of Wenshan Zhuang in the elderly OSTA index is less than -2.3, the overall level of VDR should be highly vigilant elderly osteoporosis.5. Wenshan Zhuang with age increased, male 60 years old bone formation continued to strengthen, then declined slowly, female 50 years old bone the formation of continuous strengthening, then declined slowly, after the age of 40, and continue to strengthen the absorption of bone, but overall in low bone turnover. The bone metabolism markers can reflect the bone mineral density T value of medium The.6. in Wenshan Zhuang people osteoporosis prevention and control work, should strengthen the grassroots advocacy work related knowledge, according to the osteoporosis risk and protective factors related to take comprehensive measures, the controllable risk factors, strengthen the protection factors, dynamic monitoring of bone turnover markers, give the corresponding anti osteoporosis treatment, reduce and delay the local elderly the Zhuang people of osteoporosis and osteoporotic fractures.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580

【参考文献】