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| 老年髋部骨折类型与股骨近端骨密度的关系 |
| The association between proximal femur bone mineral density and hip fracture types in elder patients |
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| DOI：10.3969/j.issn.1006.7108.2017.04.013 |
| 中文关键词: 髋部骨折类型 骨密度；股骨近端 |
| 英文关键词:Hip fracture type Bone mineral density Proximal femur |
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| 中文摘要: |
| 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 (P <0.01);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（P<0.01)。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（P <0. 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（P < 0. 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（P <0.01)。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（P <0. 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（P <0.01)。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。 |
| 英文摘要: |
| Objective To investigate the differences in proximal femur bone mineral density ( BMD) in older patients with cervical and trochanteric hip fracture. Methods A retrospective study included 520 older patients ( > 60 years) with first hip fracture. There were 237 patients who had cervical fracture including 67 males (mean age 80. 0 ± 8, 5 years) and 170 females (mean age 79. 0 ±8. 2 years) , and 283 patients who had trochanteric fracture including 95 males (mean age 80. 2±8. 4 years) and 188 females (mean age 82.4±6.7years). BMD at five regions (Neck, Troch, Inter, Total hip and Ward’s region) were compared between the two hip fracture types. Then binary logistic regression was conducted to analyze the association between BMD and hip fracture types. Results As for BMD, men with trochanteric fracture had significantly lower BMD than those with cervical fracture only at the Troch region (P< 0. 01 ). Women with trochanteric fracture had significantly lower BMD than those with cervical fracture at four regions ： Troch (P < 0. 01), Inter (P < 0. 01), Total hip (P < 0. 01), and Ward’s region (P < 0. 01). Then women were divided into three age groups ( < 70 years, 70-79 years and >79 years). In women aged 69 years and younger, only BMD of the Ward’s region (P <0.01) was significantly lower in patients with trochanteric fracture. In the intermediate age group (70 -79 years) , BMD at all five regions (P <0. 05) were all significantly lower in the trochanteric fracture group. However, in those aged 80 years and older, significantly lower BMD was only observed at the Troch region (P <0. 01) in patients with trochanteric fracture. Binary logistic regression showed that increased age and BMD of Troch, Inter, Total hip or Ward’s region were independently associated with hip fracture type in women, while only BMD of Troch region was associated with fracture type in men. Conclusion Cervical and trochanteric hip fracture patients had different levels of BMD. Moreover, the association of BMD and hip fracture type varies with age in women. |
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