目的 调查深圳市宝安区717名社区围绝经期妇女的骨密度及一般情况,探讨本地区围绝经期妇女骨量丢失情况的流行病学情况.方法 以2016年5月-10月在深圳市宝安区沙井人民医院下辖社康中心的40～60岁妇女为研究对象,将其中40～45岁、45～55岁、55 ～ 60岁中符合围绝经期诊断标准者的762例纳入此次研究,共回收问卷717份,有效回收率94.09％.采用MQD-7000超声波骨密度分析仪,检测受试者非受力侧前臂尺桡骨中远端1/3处骨密度,建立信息采集表,记录骨密度;一般人口学特征包括身高、体重、体重指数、怀孕次数、生产次数和流产次数等;以及日常行为习惯调查包括是否饮用咖啡、牛奶、浓茶,是否吸烟、饮酒,以及近5年是否经常锻炼等.最终将45 ～55岁之间,以及40 ～45岁、55 ～60岁中符合围绝经期诊断标准者纳入讨论,将检测结果以每5岁为一年龄段分组,分析每组骨密度T值与骨质疏松症患病率及相关影响因素.结果 在围绝经期妇女中有疼痛情况者极为普遍,有1个部位以上疼痛症状的妇女有456名,占63.6％,疼痛性质主要为酸痛,占56.21％.骨量损失情况及骨量减少发生率均随年龄的增加而加重,而饮用牛奶的入骨量损失情况小于不饮用牛奶的人(P＜0.05),这与有关文献报道基本一致.咖啡、浓茶、吸烟、饮酒骨量损失差异无统计学意义(P＞0.05),考虑与本次研究对象为女性,有这些生活饮食嗜好的人总体数量较小有关;近5年经常锻炼的人整体比较较小,仅占12.55％,在此次调查中显示对骨量减少影响较小.女性BMI越高,骨量减少的发生率不一定增高,经秩和检验(bonferroni校正)差异无统计学意义(P＞0.05).本研究还发现,怀孕和生产次数的增多均会增加骨量减少发生率,呈正相关.结论 处于围绝经期妇女伴有疼痛症状的比例为63.6％,骨量减少发生率随着增龄而增加,主要危险因素为增龄、怀孕和生产次数,饮用牛奶是可能保护性因素.应对围绝经期妇女和基层医务人员加强宣教,控制可能导致骨量减少的不良因素,预防和延缓绝经后骨质疏松症的发生.%Objective To investigate the bone loss of 717 cases of peri-menopausal women in Baoan district in Shenzhen city.Methods Seven hundred and sixty-two women,aged from 40 to 60 years old who visited in Community Health Service Centers of Baoan district in Shenzhen city from May 2016 to October 2016,were involved in the study,Shajing people's Hospital of Baoan District City in Shenzhen.Women who met the peri-menopausal criteria were divided into 40-45,45-55,and 55-60 years old group.Questionnaires were distributed and 717 questionnaires were retrieved (94.09％).BMD of the distal one-third of the radius and the ulna of non-dominant forearm were detected using ultrasonic bone mineral density analyzer (MQD-7000).The information of all the cases,including BMD,height,weight,BMI,and the time of pregnancy,delivery,abortion were collected and recorded.Life style investigation included drinking of coffee,milk,or dark tee,smoking,alcohol drinking,and exercise.The results were grouped in a 5-year range.The relationship between BMD T score and the incidence of osteoporosis and the risk factors were analyzed.Results In the peri-menopausal women pain was very common.Women with at least one pain site were 456 cases (63.60％).The pain was mainly soreness (56.21％).The bone loss increased with the increase of age.The loss of bone mass in the milk drinkers was less than that non-mild drinkers (P ＜ 0.05),which was consistent with the relevant literature reports.Drink of coffee or dark tee,smoking,and alcohol drinking were not relevant to bone loss (P ＞ 0.05).This might be due to the woman subjects and low number with these habits.The number of woman who often exercised in latest 5 years was few (12.55％),which had little influence to the bone mass.High BMI was not associated with low bone mass (P ＞ 0.05).The increase in the number of pregnancy and production was positively correlated with the incidence of bone loss.Conclusion In the peri-menopausal period,the proportion of women with pain symptom was 63.6％.The prevalence of bone loss increases with aging.Aging and the number of pregnancy and production are risk factors of bone loss.Regular milk drinking is protective factor.We should strengthen prevention education to the peri-menopausal women and the medical staffs,control the controllable factors of bone loss,and prevent and delay the occurrence of PMOP.
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