【摘要】 目的了解上海社区老年人群椎体骨折的患病率及其特点,并探讨城郊差异。方法在上海3个城区和2个郊区社区中,按人口年龄分布进行分层抽样,共纳入65岁以上老年人2 444名,其中男性1 456人,女性988人。所有研究对象接受基本信息问卷调查并拍摄胸腰椎X线片,按Genant椎体骨折半定量法进行结果判定;观察上海社区老年人群椎体骨折的总体和各年龄段的患病率,椎体骨折的分布及严重程度,并比较这些指标是否存在城郊差异。结果 (1)上海社区老年女性椎体骨折患病率明显高于男性(26.1%vs.20.7%),郊区椎体骨折患病率高于城区(26.2%vs.20.7%),差异均有统计学意义(P<0.05);(2)城区居民椎体骨折的患病率随年龄增加呈U型分布,男性65~69岁椎体骨折患病率为24.5%,而后出现下降,到75~79岁最低为10.5%,此后又出现上升,≥85岁组最高为33.3%;女性65~69岁椎体骨折患病率为20.0%,70~74岁降到最低为10.0%,而后逐渐上升,≥85岁组最高为35.7%;(3)在骨折类型中,T11、T12和L1三者合计占骨折椎体总数的52.4%(城区)和64.3%(郊区),T6、T7和T8三者合计占椎体骨折总数的21.4%(城区)和9.3%(郊区);1°椎体骨折的比例最高,且郊区老年人群1°椎体骨折的比例高于城区(75.8%vs.63.1%);骨折分型则以Ⅰ型楔形变最为常见,且郊区的比例大于城区比例(87.4%vs.79.6%),差异均有统计学意义(P<0.05)。结论女性、高龄以及郊区居民更易发生椎体骨折,椎体骨折好发部位在胸腰交界处和中胸段,1°和Ⅰ型骨折最常见。更多还原

【Abstract】 Objective To investigate prevalence and characteristics of vertebral fracture in community-dwelling elderly in Shanghai and to explore its difference between urban and suburban districts. Methods Stratified sampling was performed according to the age distribution of the population in 3 urban and 2 suburban communities in Shanghai. A total of 2 444 elderly over 65 years old were enrolled,including 1 456 males and 988 females. We investigated the prevalence of radiographic vertebral fractures in these subjects using Genant’s semiquantitative scoring system. The prevalence of vertebral fractures,the severity and type of vertebral fractures in each group were compared. Results( 1) The prevalence of vertebral fractures in elderly women in Shanghai community was significantly higher than that in men( 26. 1% vs.20. 7%),and the prevalence of vertebral fractures in the suburbs was higher than that in urban areas( 26. 2% vs.20. 7%).( 2) The prevalence of vertebral fractures in urban residents showed a U pattern with increasing age. It was24. 5% at the age of 65-69 years old,and it decreased and it reached to the lowest at 10. 5% at the age of 75-79 years old. Then it increased gradually and was highest for 33. 3% in the more than 85 years old group in males. The prevalence of vertebral fracture in females was 20. 0% at the age of 65-69 years old,and it reached to the lowest at 10. 0% at the age of 70-74 years old. Then it increased gradually and was highest for 35. 7% in the group more than 85 years old.( 3) T11,T12 and L1 accounted for 52. 4% of the total number of vertebral fractures( urban) and 64. 3%( suburban) T6,T7 and T8 accounted for 21. 4%( urban) and 9. 3%( suburban). Grade 1vertebral fractures were the most common. The proportion of Grade 1 in elderly in suburbs was higher than that in urban areas( 75. 8% vs. 63. 1%). Wedge deformity was the most common fracture type. The proportion of wedge deformity in elderly in suburbs was also higher than that in urban areas( 87. 4% vs. 79. 6%). Conclusion Vertebral fractures were more likely to occur in women,especially in older and rural residents. The predilection sites of vertebral fractures were thoracolumbar junction and mid-thoracic segment. The most common types of vertebral fracture were Grade 1 wedge deformity.更多还原