摘要
目的调查天津市某三级甲等医院老年住院患者骨质疏松发生情况、导致骨质疏松发生的危险因素以及伴有低钠血症的骨质疏松患者情况。方法对2496例老年住院患者血钠、血钙、血浆25羟维生素D3[25（OH）D3]、血浆甲状旁腺激素、血浆I型原胶原N末端前肽（P1NP）、β-I型胶原交联C末端肽（β-CTX）进行测定，同时以问卷调查的形式记录患者性别、年龄、身高、体重、吸烟史、饮酒史，并根据身高、体重计算患者体质指数（BMI），同时应用多因素Logistic回归分析老年患者骨质疏松发生的危险因素。结果2496例患者中有305例骨质疏松患者，患病率为12．2％，其中男性96例（31.5％）、女性209例（68．5％），男、女性骨质疏松患病率差异有统计学意义（χ^2=4．651，P=0．031）；伴有低钠血症的骨质疏松患者84例（84／305、27．5％），其中男性21例（21／84，24．8％）、女性63例（63／84、75．2％），男、女性伴有低钠血症的骨质疏松患病率差异有统计学意义（χ^2=9．251，P=0．025）。与非骨质疏松患者、血钠正常的骨质疏松患者、血钠正常的非骨质疏松患者比较，伴有低钠血症骨质疏松患者年龄更大、女性及吸烟者比例更高，BMI、血钠值、骨密度（全髋部）值及25（OH）D3水平更低，差异均具有统计学意义（F=13．783、0．861、7．146、24．520、0．548，χ^2=15．113、4．472，P=0．001、0．000、0．021、0．015、0．003、0．021、0．005）。经多因素Logistic回归分析结果显示，增龄、女性、低BMI、吸烟史、饮酒史、低25（0H）D3、低PINP及高β-CTX均为诱发老年患者骨质疏松的独立危险因素（OR=4．215、2．271、3．176、2．013、1．237、3．987、1．843、1．972，均P〈0．05）。结论老年人骨质疏松发生较普遍，多种致病因素可导致骨质疏松的发生，同时伴有低钠血症的骨质疏松患者较不�
Objective To survey a prevalence of osteoporosis and prevalence of osteoporosis combined with hyponatremia in elderly hospitalized patients, and their risk factors. Methods We enrolled 2496 elderly hospitalized patients with detected plasma levels of sodium, calcium, 25 （OH） D3, PTH, plasma PINP, and β-CTX. At the same time, sex, age, height, weight, smoking history, drinking history and BMI （ kg/m^2 ） in form of a questionnaire were recorded and calculated. The risk factors for osteoporosis were analyzed using multivariate Logistic regression method. Results The osteoporosis prevalence was 12. 2G （305/2496 inpatients）with 31.5% （96/305）in male,68. 5%（209/305）in female（χ^2 =4. 651,P=0. 031）. The prevalence of osteoporosis with hyponatremia was 27.5% （84/305）, with 24.8 % （21/84） in male and 75.2% （63/84） in female（χ^2= 9. 251 ,P= 0. 025）. As compared with three groups of non-osteoporosis, normal serum Na^＋ with and without osteoporosis,the osteoporosis patients with hyponatremia were more aged,in a higher proportion of women and smokers,in lower BMI,and in low levels of serum sodium, BMD 25 （OH） D3 （F= 13. 783,0. 861, 7. 146,24. 520,0. 548, χ^2 = 15. 113,4. 472 ; P = 0. 001,0. 000,0. 021,0. 015,0. 003, 0. 021,0. 005 ）. Multivariate Logistic regression analysis showed that aging, female, low BMI, smoking history, drinking history, low plasma 25 （OH）D3 level, low plasma PINP level,and high plasma β-CTX level were the risk factors for osteoporosis（OR =4.215,2.271,3.176,2.013,1.237,3.987,1.843,1.972;all P〈0.05）. Conclusions The osteoporosis prevalence is high in elderly patients, especially in old women. The risk factors for osteoporosis are diverse, and clinical conditions of osteoporosis patients with hyponatremia are much more severe than the others. More efforts should be viven to them and need to be focused on the complications of osteoporosis.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2017年第8期872-876,共5页
Chinese Journal of Geriatrics
