骨质疏松症患者骨折预防知信行调查及胸腰椎骨折的因素分析

doi:10.3760/cma.j.issn.1007-1245.2024.07.018

摘要/Abstract

摘要：

目的　调查骨质疏松症（OP）患者骨折预防的知信行水平，并分析患者胸腰椎骨折的危险因素。方法　本研究为横断面调查研究，选取郑州市骨科医院2020年2月至2022年11月门诊收治的OP患者320例作为研究对象，年龄45～78岁，男179例，女141例。采用问卷的方式调查OP患者骨折预防的知信行水平，根据患者是否发生胸腰椎骨折将其分为胸腰椎骨折组（35例）和非胸腰椎骨折组（285例）。采用t检验比较两组知信行得分、身高、体质量、骨密度（BMD），采用χ²检验比较两组知信行良好率、性别、年龄、糖尿病、冠心病、吸烟史、饮酒史、既往脆性骨折史、父母骨折史、糖皮质激素治疗史，采用logistic回归分析法分析OP患者胸腰椎骨折发生的危险因素。结果　OP患者骨折预防的知识维度、信念维度、行为维度总得分分别为（16.12±3.12）分、（129.02±17.50）分、（22.02±6.12）分；OP患者知识掌握、信念、行为良好率分别为66.88%（214/320）、64.22%（411/640）、53.96%（518/960）；胸腰椎骨折组知识、信念、行为总得分均低于非胸腰椎骨折组［（12.54±4.12）分比（16.56±3.00）分、（117.51±16.35）分比（130.43±17.64）分、（18.34±3.11）分比（22.47±6.49）分］，差异均有统计学意义（t=7.15、4.12、3.71，均P<0.05）；胸腰椎骨折组知识掌握、信念、行为良好率均低于非胸腰椎骨折组［40.00%（14/35）比70.18%（200/285）、34.29%（24/70）比67.89%（387/570）、28.57%（30/105）比57.08%（488/640）］，差异均有统计学意义（χ²=12.81、30.65、30.59，均P<0.05）；胸腰椎骨折组女性、年龄≥65岁、饮酒史、既往脆性骨折史、糖皮质激素治疗史占比均高于非胸腰椎骨折组，骨密度（BMD）低于非胸腰椎骨折组，差异均有统计学意义（χ²=4.05、11.73、4.36、5.73、4.65、5.55，均P<0.05）；logistic回归分析结果显示，性别［OR=3.047，95%置信区间（CI） 2.456～4.412］、年龄≥65岁（OR=5.977，95%CI 2.657～7.025）、饮酒史（OR=1.883，95%CI 1.236～2.012）、既往脆性骨折史（OR=1.919，95%CI 1.658～2.365）、糖皮质激素治疗史（OR=1.508，95%CI 1.136～1.789）均是OP患者胸腰椎骨折的危险因素（均P<0.05），BMD则是保护因素（OR=0.421，95%CI 0.211～0.741，P<0.05）。结论　OP患者骨折预防知信行水平有待提高，女性、年龄≥65岁、饮酒史、既往脆性骨折史、糖皮质激素治疗史均是OP患者胸腰椎骨折的危险因素，BMD是保护因素。

关键词:

骨质疏松症, 知信行, 胸腰椎骨折, 影响因素

Abstract:

Objective　To investigate the knowledge, belief, and behaviors of fracture prevention in patients with osteoporosis (OP), and to analyze the risk factors of thoracolumbar fractures in patients with OP. Methods　This was a cross-sectional survey study. A total of 320 patients with OP admitted to Outpatient Department, Zhengzhou Orthopedic Hospital from February 2020 to November 2022 were selected as the research objects, including 179 males and 141 females who were 45-78 years old. The levels of knowledge, belief, and behaviors of fracture prevention in the patients were investigated by questionnaire. The patients were divided into a thoracolumbar fractures group (35 cases) and a non-thoracolumbar fractures group (285 cases) according to the occurrence of thoracolumbar fractures. The scores of knowledge, belief, and behaviors, heights, weights, and bone mineral densities (BMD) were compared between the two groups by the t test. The good rates of knowledge, belief, and behaviors, and proportions of the patients with different genders and ages, diabetes, coronary heart disease, smoking history, drinking history, previous brittle fracture history, parental fracture history, and glucocorticoid treatment history were compared between the two groups by the χ² test. The risk factors for thoracolumbar fractures in the patients were analyzed by the logistic regression analysis. Results　The total scores of knowledge, belief, and behavior dimensions of fracture prevention in the patients were (16.12±3.12), (129.02±17.50), and (22.02±6.12), respectively. The good rates of knowledge mastery, belief, and behaviors in the patients were 66.88% (214/320), 64.22% (411/640), and 53.96% (518/960), respectively. The total scores of knowledge, belief, and behavior dimensions in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group [(12.54±4.12) vs. (16.56±3.00), (117.51±16.35) vs. (130.43±17.64), and (18.34±3.11) vs. (22.47±6.49)], with statistical differences (t=7.15, 4.12, and 3.71; all P<0.05). The good rates of knowledge mastery, belief, and behaviors in the thoracolumbar fracture group were lower than those in the non-thoracolumbar fracture group [40.00% (14/35) vs. 70.18% (200/285), 34.29% (24/70) vs. 67.89% (387/570), and 28.57% (30/105) vs. 57.08% (488/640)], with statistical differences (χ²=12.81, 30.65, and 30.59; all P<0.05). The proportions of women, the patients ≥65 years old, and the patients with alcohol consumption history, previous brittle fracture history, and glucocorticoid treatment history in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group, with statistical differences (χ²=4.05, 11.73, 4.36, 5.73, and 4.65; all P<0.05). The BMD of the thoracolumbar fracture group was lower than that of the non-thoracolumbar spine fracture group, with a statistical difference (t=5.55, P<0.05). The results of logistic regression analysis showed that women [odds ratio (OR)=3.047, 95% confidence interval (95%CI) 2.456-4.412], age ≥65 years (OR=5.977, 95%CI 2.657-7.025), history of alcohol consumption (OR=1.883, 95%CI=1.236-2.012), history of brittle fractures (OR=1.919, 95%CI 1.658-2.365), and history of glucocorticoid therapy (OR=1.508, 95%CI 1.136-1.789) were all risk factors for thoracolumbar fractures in the patients (all P<0.05), while the BMD was a protective factor (OR=0.421, 95%CI 0.211-0.741, P<0.05). Conclusions　The levels of knowledge, belief, and behaviors of fracture prevention in patients with OP need to be improved. Women, age ≥65 years, alcohol consumption history, previous history of brittle fractures, and history of glucocorticoid therapy are all risk factors for thoracolumbar fractures in patients with OP, and BMD is a protective factor.

Key words:

Osteoporosis, Knowledge, belief, and behaviors, Thoracolumbar fractures, Influence factors

刘建霞牛路野李亚楠朱小广.

骨质疏松症患者骨折预防知信行调查及胸腰椎骨折的因素分析 [J]. 国际医药卫生导报, 2024, 30(7): 1146-1151.

Liu Jianxia, Niu Luye, Li Yanan, Zhu Xiaoguang .

Investigation on knowledge, attitude, and practice of fracture prevention in patients with osteoporosis and analysis on risk factors of thoracolumbar fractures [J]. International Medicine and Health Guidance News, 2024, 30(7): 1146-1151.

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