【摘要】 目的探讨老年非外伤性椎体压缩骨折的危险因素。方法采用回顾性对照研究方法,分析2015年1—12月北京积水潭医院脊柱外科住院治疗的60岁以上椎体压缩性骨折患者的临床资料,收集患者的一般资料(性别、年龄、BMI、既往骨折史、既往疾病及用药史等)、骨折原因、骨折椎体部位及数量、骨密度(采用定量CT方法测量)、血骨转换指标(总Ⅰ型胶原氨基端延长肽、骨钙素、Ⅰ型胶原羧基端肽β特殊序列、25羟-维生素D3、全段甲状旁腺素)等。根据骨折原因将病例分为外伤组与非外伤组。结果共纳入355例骨质疏松性椎体压缩骨折患者。外伤组208例,年龄(70.76±7.81)岁,共计260个椎体骨折,平均每人1.25个椎体。非外伤组147例,年龄(73.65±7.71)岁,共计237个椎体骨折,平均每人1.61个椎体。经单因素分析,2组患者的年龄(t=-3.452,P=0.001)、既往椎体骨折史(χ2=15.486,P<0.001)、骨折部位(χ2=16.753,P<0.001)、骨折椎体数量(χ2=21.528,P<0.001)、骨密度值(t=4.762,P<0.001)等资料比较,差异均有统计学意义。经多因素Logistic回归分析,低骨密度是发生非外伤性椎体压缩骨折的独立危险因素(P<0.001)。结论低骨密度是非外伤性椎体压缩骨折发生的危险因素。老年人提高骨密度可能会降低非外伤性椎体压缩骨折的风险。更多还原

【Abstract】 Objective To explore the risk factors associated with the non-traumatic vertebral fracture in the elderly. Methods A total of 345 patients who were over 60 years old and with a diagnosis of osteoporotic vertebral fracture from January to December 2015,were involved in this retrospective case control study. The demographic data( sex,age,body mass index,the history of fracture,the history of chronic diseases),the cause of fracture( traumatic or non-traumatic),fractured vertebrae location and amount,bone mineral density(quantitative computed tomography method) and bone turn over markers [total procollagen type Ⅰ amino-terminal propeptide,osteocalcin,β-isomerized C-terminal telopeptides,25-( OH) VD3,parathyroid hormone]were collected and analyzed. According to the fracture causes,the cases were divided into traumatic group and non traumatic group. Results The traumatic group included 208 cases with a mean age of( 70. 76 ± 7. 81)years and a mean 1. 25 fractured vertebrae per person. The non-traumatic group included 147 cases with a mean age of(73. 65 ± 7. 71) years and a mean 1. 61 fractured vertebrae per person. The statistically significant differences were found in age( t = 3. 452,P = 0. 001),the history of vertebrae fracture( χ2= 15. 486,P <0. 001),the location of fractured vertebrae( χ2= 16. 753,P < 0. 001),the amount of fractured vertebrae( χ2=21. 528,P < 0. 001) and quantitative computed tomography( QCT)( t = 4. 762,P < 0. 001). Multiple factors logistic regression analysis demonstrated that only the low level of QCT was the risk factor of the non-traumatic vertebrae fracture in older people( P < 0. 001). Conclusion The low level of BMD is the independent risk factor associated with the non-traumatic vertebrae fracture. To enhance the BMD for the elderly could help them avoid the non-traumatic vertebrae fracture.更多还原