【摘要】 骨质疏松及骨质疏松性骨折是一个全球性公共卫生问题，具有发病率高、致死致残率高、社会医疗负担重的特点。然而，全国性的骨质疏松性骨折的流行病学数据不足。我们利用中国城镇职工基础医疗保险（Urban Employee Basic Medical Insurance, UEBMI）和城镇居民基础医疗保险（Urban Resident Basic Medical Insurance, URBMI）数据库对55岁（椎体骨折为50岁）及以上老年人群的髋部/椎体骨折进行了分析，并计算其发生率和医疗费用。研究共纳入190 560例髋部骨折（女性121 933例，男性68 509例，平均年龄77.05岁）和271 981例椎体骨折（女性186 428例，男性85 553例平均年龄70.26岁）。中国55岁及以上老年人群的髋部骨折发生率从2012年的148.75/10万缓慢下降到2016年的136.65/10万。中国50岁及以上老年人群的椎体骨折发生率从2013年的85.21/10万增加到2017年的152.13/10万。髋部骨折住院总费用五年间增长约4倍；椎体骨折的医疗费用则增长了5.45倍；无论髋部骨折还是椎体骨折，人均治疗费用稳步降低。中国城镇老年人群髋部骨折发生率达到了一个平台期，但椎体骨折发病率呈上升态势。与此同时，髋部骨折和椎体骨折的总人数和总相关医疗花费仍然在迅速增长。研究结果提示我们应更加重视骨质疏松症的管理和骨质疏松骨折的防控。更多还原

【Abstract】 Osteoporosis and osteoporotic fractures are a public health problem and it has the characteristics of high morbidity, mortality and disability, and heavy social medical burden. However, there is a lack of national epidemiological data on osteoporotic fractures. We analyzed the data on hip/vertebral fractures in the elderly population aged 55 years(50 years for vertebral fractures) and above using the Chinese Urban Employee Basic Medical Insurance(UEBMI)and Chinese Urban Resident Basic Medical Insurance(URBMI) databases. A total of 190 560 hip fractures(121 933women and 68 509 men, mean age 77. 05 years) and 271 981 vertebral fractures(186 428 women and 85 553 men, mean age 70. 26 years) were included in the study. The incidence of hip fracture among Chinese aged 55 and above decreased from 148. 75/100 000 person-years in 2012 to 136. 65/100 000 person-years in 2016. The incidence of vertebral fractures in the elderly population aged 50 years and above in China increased from 85. 21/100 000 person-years in 2013 to 152. 13/100 000 person-years in 2017. Total hospital costs for hip fractures increased nearly four-fold in five years. The cost of treatment for vertebral fractures increased 5. 45 times in five years. The incidence of hip fracture has reached a plateau in Chinese urban elderly population, but the incidence of vertebral fracture is on the rise. At the same time, the absolute number of hip and vertebral fractures and the associated medical costs continue to increase rapidly. This situation suggests that we should pay more attention to the management of osteoporosis and the prevention of osteoporotic fractures.更多还原