摘要
目的:了解围绝经期妇女骨量情况,分析引起骨量流失的因素,提高围绝经期妇女的保健质量。方法:选择2000-01/2003-12在广西柳州市妇幼保健院院门诊进行超声骨密度检测的围绝经期妇女860人。按年龄分为2组,40～49岁组444人,50～59岁组416人。采用超声骨密度仪对所有测试者的跟骨进行检测,检测后采用自编问卷调查以获得相关因素资料,问卷内容包括年龄,孕产史,哺乳时间,体育运动,是否绝经,是否补充钙剂及激素替代疗法,是否有影响骨量情况的疾病如慢性肾脏病、慢性消化不良、严重肝病、甲状腺功能亢进症、肾结石病、糖尿病等,是否长期使用糖皮质激素类药物。问卷统一格式,统一印制。在问卷填写过程中,作者使用相同的指导语,由测试者按照填写要求自行完成。如无法自己填写,由作者按照测试者的回答完成问卷调查。问卷采用无记名形式,当场收回。骨质疏松评定标准:按照世界卫生组织的骨质疏松诊断标准:骨矿含量或骨密度较成年人骨量峰值减低不超过1个标准差,T-评分>-1为正常;骨矿含量或骨密度较成年人骨量峰值减低1-2.5个标准差,-2.5<T-评分<-1为骨量减少;骨矿含量或骨密度较成年人骨量峰值减低2.5个标准差以上,T-评分≤-2.5为骨质疏松;骨矿含量或骨密度较成年人骨量峰值减低2.5个标准差以上并且出现了一处或多处骨折为严重骨质疏松。这些标准可用于中轴或外周骨的测定。主要观察两组骨量分布特点及绝经与骨量的关系。组间比较采用χ2检验。结果:发放问卷860份,回收合格860问卷份,有效率100%。①骨量分布特点:40～49岁组444例,骨量减少发生率为25.7%(114/444),骨质疏松的发生率为10.8%(48/444);50～59岁组416例,骨量减少发生率为34.6%(144/416),骨质疏松的发生率为21.2%(88/416),50～59岁组骨量减少及骨质疏松的发生率明显高于40～49岁组(55.8%,36.5%,χ2=32.17,P<0.05)。②绝经与骨量的关系:骨量流失包含骨量减少及骨质疏松。40～49岁组绝经妇女69例,骨量流失的发生率为47.8%(33/69),未绝经妇女375例,骨量流失的发生率为34.4%(129/375),绝经妇女骨量流失的发生率明显高于未绝经妇女(χ2=4.53,P<0.05)。5059岁组绝经妇女352例,骨量流失的发生率为58.6%(206/352),未绝经妇女64例,骨量流失的发生率为40.6%(26/64),绝经妇女骨量流失的发生率明显高于未绝经妇女(χ2=7.03,P<0.05)。结论:围绝经期妇女骨量的减少及骨质疏松的发生率随年龄增高而增加,绝经期妇女骨量减少及骨质疏松的发生率明显高于未绝经妇女。
AIM: To investigate the bone mass of perimenopausal women, analyze the factors leading to the loss of bone mass, and improve the quality of health care in perimenopausal women. METHODS: Totally 860 perimenopausal women, who received detection of broadband ultrasound attenuation in the clinic of Liuzhou Hospital of Women and Children's Health Care between January 2000 and December 2003, were divided into 2 groups according to their age: 40 to 49-year-old group (n=444) and 50 to 59-year-old group (n=416). All the subjects received detection of calcaneus with ultrasound bone densitometry, and then they were surveyed with the self-designed questionnaire to obtain the data of related factors, the contents of the questionnaire included age, history of pregnancy and delivery, lactation time, physical exercise, menopause or not, whether having received calcium supplementation and hormone replacement therapy or not, whether having the diseases affected bone mass, such as chronic renal disease, chronic dyspepsia, severe hepatopathy, hyperthyreosis, renal calculosis, diabetes, etc., whether taking drugs of glucocorticoid for a long time or not; The form of the questionnaires was unified and printed together; The subjects finished the questionnaire by their own under the same instruction from the authors; Those could not be filled by the subjects themselves were finished by the authors according to the answers of the subjects. The questionnaires were filled without recording the names and collected back on the spot. Evaluation criteria of osteoporosis referred to the diagnostic criteria of osteoporosis set by WHO: As compared with the peak value of bone mass in adults, the bone mineral content or bone mineral density decreased by less than 1 standard deviation (T-score > -1) was taken as normal; decreased by 1 to 2.5 standard deviations (-2.5 < T-score < -1) as reduce of bone mass; decreased by more than 2.5 standard deviations (T-score ≤ -2.5) as osteoporosis; decreased by more than 2.5 standard deviations and there was one or more fractures as severe osteoporosis; The above standards could be used for the determination of core or peripheral bones. The distributive characteristics of bone mass and the association between menopause and bone mass were mainly observed in both groups. The χ2 test was used for the intergroup comparison. RESULTS: A total of 860 questionnaires were sent out, and all were qualified and collected back, the effective rate was 100%. ① The distributive characteristics of bone mass: In the 40 to 49-year-old group (n=444), the incidence rates of reduce of bone mass and osteoporosis were 25.7% (114/444) and 10.8% (48/444) respectively; In the 50 to 59-year-old group (n=416), the incidence rates of reduce of bone mass and osteoporosis were 34.6% (144/416) and 21.2% (88/416) respectively; The incidence rate of reduce of bone mass and osteoporosis were significantly higher in the 50 to 59-year-old groupthan in the 40 to 49-year-old group (55.8%, 36.5%, χ2=32.17, P < 0.05). ② Association between menopause and bone mass: The osteopeniaincluded the reduce of bone mass and osteoporosis. In the 40 to 49-year-old group, the incidence rate of osteopeniawas obviously higher in the menopausal women [47.8% (33/69)] than in the non-menopausal women [34.4% (129/375)] (χ2=4.53, P < 0.05); In the 50 to 59-year-old group, the incidence rate of osteopeniawas obviously higher in the menopausal women [58.6% (206/352)] than in the non-menopausal women [40.6% (26/64)] (χ2=7.03, P < 0.05). CONCLUSION: In the perimenopausal period,the incidence rates of osteopeniaand osteoporosis are increased with age.The incidence rates of osteopeniaand osteoporosis are obviously higher in menopausal women than in non-menopausal women
出处
《中国临床康复》
CSCD
北大核心
2005年第23期182-183,共2页
Chinese Journal of Clinical Rehabilitation
