基于股骨头坏死数据库分析激素性股骨头坏死的发病特征
Analysis of the characteristics of steroid-induced avascular necrosis of the femoral head based on the database of avascular necrosis of the femoral head
  
DOI:10.3969/j.issn.1006-7108.2020.07.010
中文关键词:  股骨头坏死  激素  流行病学  数据库
英文关键词:femoral head necrosis  hormone  epidemiology  database
基金项目:中国博士后科学基金项目(2017M613179);陕西省长安郭氏骨伤学术流派工作室建设项目(陕中医药发[2018]40)
作者单位
李欢欢1 李军2 王秋霞1 陈冬冬1 许鹏3 鲁超3* 1.陕西中医药大学陕西 咸阳 712000 2.宝鸡市中医医院陕西 宝鸡 721000 3.西安交通大学附属红会医院陕西 西安 710000 
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中文摘要:
      目的 分析激素性股骨头坏死的发病特征,为激素性股骨头坏死的早期预防和诊断提供参考。方法 利用股骨头坏死数据库,回顾性分析2014年1月至2017年12月住院治疗的激素性股骨头坏死患者,提取患者的基本信息(性别、年龄、职业、文化程度、BMI值)、疾病情况(发病部位、病程、严重程度、中医证型、首次就诊医院等级)、使用激素情况(原发病、使用时间、药品名称、药物方法、每日使用量、每日使用次数)等相关资料进行归纳分析。结果 共纳入股骨头坏死患者1062例,其中激素性股骨头坏死患者471例,最终纳入438例。激素性股骨头坏死的发病特征为:(1)患者主要基本情况:女性271例(61.87%);年龄在51~60岁的患者223例(50.91%);职业为农民的患者224例(51.14%);初中文化程度的患者123例(28.08%);BMI值大多在正常范围内的患者327例(74.66%)。(2)疾病情况:双侧发病的患者314例(71.69%);病程≤3个月的患者163例(37.21%);ARCO分期多属中晚期,其中ARCOⅢ期患者168例(38.36%);首次就诊在一级医院的患者187例(42.69%)。(3)使用激素情况:原发病中自身免疫性疾病的患者189例(43.15%);使用波尼松的患者162例(36.97%);使用激素时间≥2年以上的患者112例(25.57%);药物用法中口服患者171例(39.04%);每日使用激素含量10~20 mg以内的患者127例(29.0%);每日使用激素两次的患者128例(29.23%)。结论 激素性股骨头坏死发病特征主要为:41~60岁的有原发病史的女性重体力劳动者,初中及以下文化程度为主,62.10%的患者专科医院就诊时已为ARCOⅢ、Ⅳ期,使用激素史≥1年占54.34%,每日使用激素含量多为10~20 mg、次数多为每日两次。
英文摘要:
      Objective To analyze the characteristics of steroid-induced avascular necrosis of the femoral head, and to provide reference for the early prevention and diagnosis of steroid-induced avascular necrosis of the femoral head. Methods Using the database of avascular necrosis of femoral head, the hospitalized patients with steroid-induced avascular necrosis of femoral head from January 2014 to December 2017 were retrospectively analyzed. The basic information of patients (gender, age, occupation, educational level, BMI value), disease status (location, course, severity, TCM syndromes, hospital grade of first visit), and the use of hormones (primary disease, intensive use), the hormone status (primary disease, time of use, drug name, drug method, daily dosage, daily use times) and other related data were extracted and analyzed. Results There were 1062 cases of femoral head necrosis. Among those, 471 of them were steroid-induced femoral head necrosis, and 438 were included. The characteristics of steroid-induced avascular necrosis of the femoral head were as follows. (1) The main basic conditions of the patients showed that 271 were women (61.87%), 223 patients (50.91%) were aged from 51 to 60 years old, 224 patients (51.14%) were farmers, 123 patients (28.08%) were with junior middle school education, and BMI values of 327 patients (74.66%) were in the normal range. (2) The disease situation appeared that 314 patients (71.69%) were with bilateral disease, 163 patients (37.21%) had disease course less than 3 months, 168 patients (38.36%) were at ARCO stage III, and 187 patients (42.69%) had their first visit to a doctor at a grade I hospital. (3) The hormone use showed that 189 patients (43.15%) were with autoimmune diseases in primary diseases, 162 patients (36.97%) used Bonisone, 112 patients (25.57%) used hormone for more than two years, 171 patients (39.04%) used hormone orally, 127 patients (29.0%) used hormone less than 10-20 mg daily, 128 patients (29.23%) used hormone twice a day. Conclusion The main characteristics of the onset of steroid-induced avascular necrosis of femoral head include 41-60-year-old female heavy manual workers with primary history, junior middle school and lower education level, 62.10% of ARCO III and IV stage on the visit in our hospital, 54.34% of the use of hormones for more than one year, and the daily use of 10-20 mg hormones with twice a day.
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