老年髋部骨折类型与股骨近端骨密度的关系

发布时间：2018-07-10 19:23

本文选题：髋部骨折类型 + 骨密度　；参考：《中国骨质疏松杂志》2017年04期

【摘要】：目的探讨老年股骨颈骨折与转子间骨折患者在股骨近端骨密度(BMD)上的不同特点。方法回顾性研究520例60岁及60岁以上初次髋部骨折患者:股骨颈骨折237例,男67例,平均年龄80.0±8.5岁,女170例,平均年龄79.0±8.2岁;转子间骨折283例,男95例,平均年龄80.2±8.4岁,女188例,平均年龄82.4±6.7岁。比较两种髋部骨折患者健侧股骨近端五个区域(股骨颈、大转子、转子间、全髋部、Ward区)的BMD,并采用二分类logistic回归分析探讨股骨近端不同区域BMD与髋部骨折类型之间的关系。结果男性转子间骨折患者只有大转子BMD显著低于同性股骨颈骨折患者,差异有统计学意义(P0.01);而女性转子间骨折患者大转子、转子间、全髋部、Ward区的BMD显著低于同性股骨颈骨折患者,差异均有统计学意义(P0.01)。女性按年龄分层后,60~69岁转子间骨折患者只有Ward区BMD显著低于股骨颈骨折患者,差异有统计学意义(P0.05);70~79岁转子间骨折患者五个区域BMD均显著低于股骨颈骨折患者,差异有统计学意义(P0.05);大于79岁转子间骨折患者只有大转子BMD显著低于股骨颈骨折患者,差异有统计学意义(P0.01)。二分类Logistic回归分析发现:女性中增龄、大转子、转子间、全髋部以及Ward区的BMD与髋部骨折类型存在统计学关联(P0.01),而男性中只有大转子BMD与髋部骨折类型存在统计学关联(P0.01)。结论股骨颈骨折患者和转子间骨折患者存在不同的BMD水平,女性股骨近端BMD与髋部骨折类型的关系随着年龄的变化而变化。
[Abstract]:Objective to investigate the characteristics of proximal femoral bone mineral density (BMD) in elderly patients with femoral neck fracture and intertrochanteric fracture. Methods A retrospective study of 520 cases of primary hip fracture aged 60 years and over: 237 cases of femoral neck fracture, 67 males with an average age of 80.0 卤8.5 years, 170 females with an average age of 79.0 卤8.2 years, 283 patients with intertrochanteric fracture, 95 males with an average age of 80.2 卤8.4 years. 188 cases were female, the average age was 82.4 卤6.7 years old. The BMDs of the proximal femur (femoral neck, greater trochanter, intertrochanteric region, total hip ward area) were compared between two kinds of hip fracture patients, and the relationship between the proximal femur logistic and hip fracture types was studied by two classification logistic regression analysis. Results the BMD of male intertrochanteric fracture was significantly lower than that of the same sex femoral neck fracture (P0.01), while that of female intertrochanteric fracture was significantly lower than that of the same sex femoral neck fracture (P0.01). The BMD in the total hip ward area was significantly lower than that in the same sex femoral neck fracture patients (P0.01). The BMD in patients with intertrochanteric fracture at 60 ~ 69 years old was significantly lower than that in patients with femoral neck fracture (P0.05). The BMD in five regions of patients with intertrochanteric fracture was significantly lower than that in patients with femoral neck fracture. The difference was statistically significant (P0.05); only greater trochanteric BMD in patients with intertrochanteric fractures was significantly lower than that in femoral neck fractures (P0.01). Logistic regression analysis showed that BMD in female patients with middle age, greater trochanter, total hip and Ward area were significantly correlated with hip fracture type (P0.01), while only large trochanter BMD was associated with hip fracture type in males (P0.01). Conclusion there are different levels of BMD in patients with femoral neck fracture and intertrochanteric fracture. The relationship between proximal femur BMD and hip fracture type changes with age.
【作者单位】：安徽医科大学中国人民解放军陆军总医院临床学院骨科;
【分类号】：R683

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