成都地区成人股骨头坏死流行病学研究

doi:10.3969/j.issn.1006-9771.2018.08.018

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (8): 970-974.doi: 10.3969/j.issn.1006-9771.2018.08.018

成都地区成人股骨头坏死流行病学研究

唐涛, 苟远涛, 唐俊, 何舰, 牟帅, 赵亮, 臧振峰, 徐练, 杨梅, 李燕

重庆医科大学附属医院,四川省八一康复中心(四川省康复医院)骨科·骨关节康复科,四川成都市 610000

收稿日期:2018-05-30 修回日期:2018-07-20 出版日期:2018-08-25 发布日期:2018-08-20
通讯作者: 唐涛。E-mail: 2094850136@qq.com
作者简介:唐涛(1963-),男,汉族,重庆市人,主任医师,主要研究方向：骨关节病。
基金资助:
四川省卫生和计划生育委员会重点课题(No. 16ZD042)

Epidemiologic Study of Adult Femoral Head Osteonecrosis in Chengdu, China

TANG Tao, GOU Yuan-tao, TANG Jun, HE Jian, MOU Shuai, ZHAO Liang, ZANG Zhen-feng, XU Lian, YANG Mei, LI Yan

The Affiliated Hospital of Chongqing Medical University, Sichuan Bayi Rehabilitation Center, Sichuan Provincial Rehabilitation Hospital, Chengdu, Sichuan 610000, China

Received:2018-05-30 Revised:2018-07-20 Published:2018-08-25 Online:2018-08-20
Contact: TANG Tao. E-mail: 2094850136@qq.com

摘要/Abstract

摘要： 目的调查成都地区成人股骨头坏死的患病情况及发病特征,并进一步探讨相关危险因素。方法 2016年1月至2018年2月,自行设计调查表格,采用入户或现场问卷调查的方式,对544例(797髋)股骨头坏死患者相关因素进行调查,包括患者一般情况、危险因素、诊断、分期及治疗情况等。并在此基础上,对上述因素进行统计分析。结果 544例患者,其中男性392例,女性152例,男女之比为2.58∶1;年龄19~90岁,平均55岁;双侧同时发生股骨头坏死253例(46.51%);初次诊断股骨头坏死中国际骨循环学会分期,Ⅰ期3.64%,Ⅱ期6.15%,Ⅲ期8.41%,Ⅳ期81.81%。病因构成为酒精性(52.39%)、激素性(16.18%)、创伤性(11.58%)、先髋发育不良性(5.88%)及其他类型(13.97%)。结论成都地区成人股骨头坏死男性发病率高于女性;疾病分期以Ⅲ~Ⅳ期所占比例最大;酒精或激素的大量摄入是导致成人股骨头坏死的主要原因,其中男性以酒精性为主,女性以激素性为主。

关键词: 股骨头, 骨坏死, 成人, 流行病学, 危险因素

Abstract: Objective To investigate the morbidity and characteristics of adult osteonecrosis of the femoral head (ONFH) in Chengdu, and to further explore its related risk factors.Methods Self-designed questionnaires were used to collect data by the way of household or field survey. From January,2016 to February, 2018, a total of 544 cases (797 hips) diagnosed as ONFH were included in the study. The medical data including general condition, risk factors, diagnosis, disease stages and treatment were collected. Based on the data, the risk factors were analyzed statistically.Results The average age of 544 patients (392 males and 152 females) was 55 years old (range: 19 to 90 years); the bilateral incidence was 46.51% (253 cases). The proportion of Association Research Circulation Osseous stages was accounted respectively 3.64% for stage I, 6.15% for stage II, 8.41% for stage III and 81.81% for stage IV when confirmed ONFH initially. In all the reasons of ONFH, 52.39% were alcohol-associated osteonecrosis, 16.18% for steroid-induced osteonecrosis, 11.58% for traumatic osteonecrosis, 5.88% for dysplastic osteonecrosis, and 13.97% for other reasons.Conclusion The incidence of ONFH was higher in men than in women. Stages III-IV accounted for the highest proportion. The high intake of alcohol or overuse of steroid was the leading causes of adult ONFH, among which alcohol-associated osteonecrosis was the main for the males and steroid-induced osteonecrosis for the females.

Key words: femoral head, osteonecrosis, adult, epidemiology, risk factors

中图分类号:

R681.8

唐涛, 苟远涛, 唐俊, 何舰, 牟帅, 赵亮, 臧振峰, 徐练, 杨梅, 李燕. 成都地区成人股骨头坏死流行病学研究[J]. 《中国康复理论与实践》, 2018, 24(8): 970-974.

TANG Tao, GOU Yuan-tao, TANG Jun, HE Jian, MOU Shuai, ZHAO Liang, ZANG Zhen-feng, XU Lian, YANG Mei, LI Yan. Epidemiologic Study of Adult Femoral Head Osteonecrosis in Chengdu, China[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(8): 970-974.

参考文献

[1] Liu TG, Chen WH.Research progress of epidemiology about nontraumatic osteonecrosis of the femoral head[J]. Med Recapitulate, 2009, 15(17): 2637-2639.
[2] Wang XS, Zhuang QY, Weng XS, et al.Etiological and clinical analysis of osteonecrosis of the femoral head in Chinese patients[J].Chin Med J (Engl), 2013, 126(2): 290-295.
[3] Mont MA, Zywiel MG, Marker DR, et al.The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review[J]. J Bone Joint Surg Am, 2010, 92(12): 2165-2170.
[4] Fukushima W, Fujioka M, Kubo T, et al.Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head[J]. Clin Orthop Relat Res, 2010, 468(10): 2715-2724.
[5] Kang JS, Park S, Song JH, et al.Prevalence of osteonecrosis of the femoral head: a nationwide epidemiologic analysis in Korea[J]. J Arthroplasty, 2009, 24(8): 1178-1183.
[6] Roth A, Beckmann J, Bohndorf K, et al.S3-Guideline non-traumatic adult femoral head necrosis[J]. Arch Orthop Trauma Surg, 2016, 136(2): 165-174.
[7] Ficat RP.Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment[J]. J Bone Joint Surg Br, 1985, 67(1): 3-9.
[8] 李子荣. 股骨头骨坏死的 ARCO 分期[J]. 中华外科杂志, 1996, 34(3): 186-187.
[9] Jones LC, Hungerford DS.Osteonecrosis: etiology, diagnosis, and treatment[J]. Curr Opin Rheumatol, 2004, 16(4): 443-449.
[10] Gao YH, Li SQ, Wang YF, et al.Arthroplasty in patients with extensive femoral head avascular necrosis[J]. Int Orthop, 2015, 39(8): 1507-1511.
[11] Ikeuchi K, Hasegawa Y, Seki T, et al.Epidemiology of nontraumatic osteonecrosis of the femoral head in Japan[J]. Mod Rheumatol, 2015, 25(2): 278-281.
[12] Zalavras CG, Lieberman JR.Osteonecrosis of the femoral head: evaluation and treatment[J]. J Am Acad Orthop Surg, 2014, 22(7): 455-464.
[13] Shah KN, Racine J, Jones LC, et al.Pathophysiology and risk factors for osteonecrosis[J]. Curr Rev Musculoskelet Med, 2015, 8(3): 201-209.
[14] Mont MA, Cherian JJ, Sierra RJ, et al.Nontraumatic osteonecrosis of the femoral head: where do we stand today? a ten-year update[J]. J Bone Joint Surg Am, 2015, 97(19): 1604-1627.
[15] Choi HR, Steinberg ME, Cheng EY.Osteonecrosis of the femoral head: diagnosis and classification systems[J]. Curr Rev Musculoskelet Med, 2015, 8(3): 210-220.
[16] Cui L, Zhuang Q, Lin J, et al.Multicentric epidemiologic study on six thousand three hundred and ninety five cases of femoral head osteonecrosis in China[J]. Int Orthop, 2016, 40(2): 267-276.
[17] 康鹏德,王浩洋,杨静,等. 282 例患者住院治疗股骨头坏死相关因素的分析[J]. 中华关节外科杂志(电子版), 2013, 7(5): 3-6.
[18] Wang Y, Li Y, Mao K, et al.Alcohol-induced adipogenesis in bone and marrow: a possible mechanism for osteonecrosis[J]. Clin Orthop Relat Res, 2003, 410(5): 213-224.
[19] Tsai SW, Wu PK, Chen CF, et al.Etiologies and outcome of osteonecrosis of the femoral head: Etiology and outcome study in a Taiwan population[J]. J Chin Med Assoc, 2016, 79(1): 39-45.
[20] Kubo T, Ueshima K, Saito M, et al.Clinical and basic research on steroid-induced osteonecrosis of the femoral head in Japan[J]. J Orthop Sci, 2016, 21(4): 407-413.
[21] Shah SN, Kapoor CS, Jhaveri MR, et al.Analysis of outcome of avascular necrosis of femoral head treated by core decompression and bone grafting[J]. J Clin Orthop Trauma, 2015, 6(3): 160-166.
[22] Weinstein RS, Hogan EA, Borrelli MJ, et al.The pathophysiological sequence of glucocorticoid-induced osteonecrosis of the femoral head in male mice[J]. Endocrinology, 2017, 158(11): 3817-3831.
[23] 魏立友,孟和,徐文娟, 等. 股骨头缺血性坏死病因相关性研究[J]. 实用骨科杂志, 2011, 17(5): 423-426.
[24] 陈玉, 李洪久. 沈阳五所医院非创伤性股骨头坏死流行病学调查研究[J]. 辽宁中医药大学学报, 2014, 16(10): 191-193.
[25] 张崇耀,李峻辉,宁亚功. 股骨头坏死发病机制探讨[J]. 中华临床医师杂志(电子版), 2011, 5(6): 1705-1707.
[26] Yoon BH, Kim T, Shin IS, et al.Alcohol intake and the risk of osteonecrosis of the femoral head in Japanese populations: a dose-response meta-analysis of case-control studies[J]. Clin Rheumatol, 2017, 36(11): 2517-2524.
[27] 王荣田,陈卫衡,林娜,等. 股骨头坏死的病因构成及发病特征分析[J]. 中国骨与关节损伤杂志, 2009, 24(9): 792-795.

成都地区成人股骨头坏死流行病学研究

Epidemiologic Study of Adult Femoral Head Osteonecrosis in Chengdu, China

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