黄河滩区居民髋关节疾病患病率及其影响因素的调查研究

摘要

目的 了解黄河滩区居民髋关节疾病患病现状及相关影响因素,为防治髋关节疾病提供依据.方法2016年5—6月,采用普查的方法,对河南省台前县常住居民374 701人进行髋关节疾病筛查,对体格检查发现的疑似病例采用影像学检查确诊.以既往明确诊断为髋关节疾病患者为病例组,按照与病例组同性别、年龄相差<3岁、居住地相邻的原则,以1∶1的比例,选取无髋关节疾病者为对照组,采用自行设计的问卷调查两组人口学特征、烟酒嗜好、激素使用情况、疾病史及髋关节疾病家族史等.结果 本研究新确诊髋关节疾病836例,既往髋关节疾病1 751例,共有患者2 587例,粗现患率6.90‰;男性患者1 107例,粗现患率5.67‰,女性患者1 480例,粗现患率8.24‰;0~14岁、15~59岁、≥60岁居民粗现患率分别为7.51‰、4.89‰、14.81‰;疾病分布以发育性髋关节发育不良〔45.46% (1 176/2 587)〕、股骨头坏死〔43.53%(1 126/2 587)〕为主.多因素Logistic回归分析显示,家庭总收入〔2 500~4 999 元 / 月:OR=0.564,95%CI(0.374,0.848);5 000~9 999 元 / 月:OR=0.688,95%CI(0.517,0.914);≥ 10 000 元 / 月:OR=0.671,95%CI(0.554,0.813)〕、使 用 激 素〔OR=15.684,95%CI(8.361,29.421)〕、创伤股骨颈骨折〔OR=59.970,95%CI(14.679,245.012)〕、髋关节疾病家族史〔OR=10.499,95%CI(4.491, 24.539)〕是居民发生髋关节疾病的影响因素(P<0.05).结论 台前县居民髋关节疾病具有较高的现患率,以发育性髋关节发育不良和股骨头坏死为主要类型,较低的家庭总收入、使用激素、创伤股骨颈骨折、髋关节疾病家族史是居民发生髋关节疾病的危险因素.%Objective To investigate the prevalence of hip joint disease and its associated factors in Yellow River beach areas in Henan province,providing a basis for prevention and treatment of this disease.Methods We conducted this survey from May to June 2016.The enrolled participants were 374 701 permanent residents in Taiqian county,Henan province attending general hip joint disease screening.The suspected hip joint disease cases found by physical examination were diagnosed by following imaging examination.Those were diagnosed with hip joint disease in the past,were assigned to the case group,and sex-,age- and number-matched residents without hip joint disease who lived adjacent to the place of hip joint disease cases were assigned to the control group.We used a self-designed questionnaire to collect their data such as demographic characteristics, smoking habit,drinking habit,hormone treatment status,medical history and family history of hip joint disease.Results Of the participants,there were 2 587 cases of hip joint disease(including 836 newly diagnosed cases and 1 751 diagnosed in the past;1 107 males and 1 480 females),with a crude prevalence of 6.90‰;the crude prevalence of hip joint disease was 5.67‰ for males,8.24‰ for females,7.51‰ for age group of 0-14 years,4.89‰ for age group of 15-59 years,and 14.81‰ for age group of ≥60 years;the two major types of diseases were developmental dysplasia of the hip〔45.46%(1 176/2 587)〕 and femoral head necrosis 〔43.53%(1 126/2 587)〕.Multivariate Logistic regression analysis showed that total household income〔2 500-4 999 yuan per month:OR=0.564,95%CI(0.374,0.848);5 000-9 999 yuan per month:OR=0.688,95%CI(0.517, 0.914);≥10 000 yuan per month:OR=0.671,95%CI(0.554,0.813)〕,hormone treatment 〔OR=15.684,95%CI(8.361, 29.421)〕,traumatic femoral neck fracture 〔OR=59.970,95%CI(14.679,245.012)〕 and family history of hip joint disease 〔OR=10.499,95%CI(4.491,24.539)〕 were the associated factors for the residents with hip joint disease(P<0.05). Conclusion The prevalence of hip joint disease in Taiqian county is high,and the two major types are developmental dysplasia of the hip and femoral head necrosis.Low total household income,hormone treatment,trauma femoral neck fracture and family history of hip joint disease are the risk factors for hip joint disease.