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目的探讨老年人群脆性骨折的临床特点及与骨密度(BMD)、骨代谢标记物的关系,为老年人脆性骨折的防治提供依据。方法选取2009年1月至2013年12月在我院骨质疏松门诊初诊的老年脆性骨折患者(年龄≥65岁),记录骨折部位、次数,同时测定患者体质量指数(BMI)、BMD、尿钙/尿肌酐比(u Ca/Cr)、血钙、血磷、骨碱性磷酸酶(BAP)、骨钙素(OC)、I型胶原羧端末肽(β-CTX)和25-羟维生素D[25-(OH)D]等指标。按骨折部位分为椎体骨折组、髋部骨折组及其他部位骨折组,按骨折次数分为单次骨折组和多次骨折组。采用SPSS 19.0软件进行统计学分析。结果共有1 072例患者发生1 241例次脆性骨折,椎体骨折439例次,髋部骨折112例次,其他部位骨折690例次,其中162例患者有多次多部位骨折。所有患者骨量减少检出率达95.0%,其中骨质疏松检出率为55.1%。不同部位骨折各组患者的年龄、BMI、BMD差异均具有统计学意义(P<0.05或P<0.01),而u Ca/Cr、血钙、血磷、OC、β-CTX和25-(OH)D差异均无统计学意义(P>0.05)。单次骨折组和多次骨折组比较,两组年龄和BMD差异均具有统计学意义(P<0.05或P<0.01),而BMI、血钙、血磷、BAP、OC、β-CTX、25-(OH)D和u Ca/Cr组间比较差异无统计学意义(P>0.05)。结论老年人群的脆性骨折与年龄和BMD密切相关,改善BMD有助于减少再次脆性骨折的发生,对高龄患者尤其重要。
Objective To investigate the clinical features of elderly patients with brittle fracture and its relationship with bone mineral density (BMD), markers of bone metabolism and provide the basis for the prevention and treatment of brittle fracture in the elderly. Methods Aged patients (≥65 years old) with first diagnosis of osteoporosis in our hospital from January 2009 to December 2013 were selected. The fracture site and frequency were recorded. The body mass index (BMI), BMD, urine Calcium / creatinine ratio (u Ca / Cr), serum calcium, serum phosphorus, bone alkaline phosphatase (BAP), osteocalcin (OC), collagen type I carboxybetaine (β-CTX) and 25- D [25- (OH) D] and other indicators. According to the fracture site is divided into vertebral fracture group, hip fracture group and other parts of the fracture group, according to the fracture frequency is divided into single fracture group and multiple fracture group. SPSS 19.0 software was used for statistical analysis. Results A total of 1 072 patients underwent 1 241 cases of secondary fragility fracture, 439 cases of vertebral fracture, 112 cases of hip fracture and 690 cases of other fractures, of which 162 cases had multiple fracture. The detection rate of osteopenia in all patients was 95.0%, of which the detection rate of osteoporosis was 55.1%. There were significant differences in age, BMI and BMD between different groups of fractures (P <0.05 or P <0.01), while uCa / Cr, serum calcium, ) D were no significant difference (P> 0.05). There was significant difference between the two groups in age and BMD (P <0.05 or P <0.01), while the BMI, serum calcium, phosphorus, BAP, OC, β-CTX, There was no significant difference between - (OH) D and u Ca / Cr groups (P> 0.05). Conclusion The elderly patients with brittle fracture and age and BMD are closely related to improve BMD can help reduce the occurrence of fragility fracture again, especially for elderly patients.