2008~2014年北医三院骨科脊柱退行性疾病的住院人群特征分析

An analysis of social characteristics of hospitalized spinal degenerative disease patients in the orthopedic department of Peking University Third Hospital during a period of 2008 to 2014

中文关键词:  脊柱退行性疾病  颈椎退行性变  胸椎退行性变  腰椎退行性变  住院人群  人口学特征

英文关键词:Spinal degenerative diseases  Cervical degenerative diseases  Thoracic degenerative diseases  Lumber degenerative diseases  Hospitalized patient  Characteristics of patients

中文摘要:

  【摘要】 目的：探讨人口学特征与脊柱退行性疾病（spinal degenerative diseases，SDD）的相关性，为脊柱退行性疾病的预防和诊疗、降低患病率提供相关依据。方法：根据2008年1月1日～2014年12月31日北京大学第三医院骨科电子病历数据，纳入年龄≥18岁首次手术治疗的脊柱退行性疾病患者。分析其人口学特征（如年龄、性别、职业、出生地、民族以及伴随疾病）与脊柱退行性疾病的相关性，采用描述性统计和卡方检验。结果：共纳入符合标准的SDD患者22951例，男性12838例（55.9%），女性10113例（44.1%）。平均年龄52.4±11.6岁（18～86岁）。其中颈椎退行性疾病（CDD）10941例（47.7%），胸椎退行性疾病（TDD）588例（2.6%），腰椎退行性疾病（LDD）11422例（49.8%）；不同部位SDD患者的性别、年龄、职业及地区分布差异均有统计学意义（P<0.001），而民族分布差异无统计学意义（P>0.05）。在CDD患者中，以男性（55.9％）、50～54岁（18.2%）、办公室人员（22.2%）占比高；在TDD患者中，以男性（57.5%）、农民（26.5%）占比高；在<45岁的LDD患者中，男性占比高（χ2=66.56，P<0.001），特别是在18～29岁年龄组中，男性占比明显增高（8.7%∶3.2%）；然而，在>45岁的LDD患者中，女性占比高（χ2=17.50，P<0.05）。有伴随疾病者8160例，其中伴有骨质疏松（404例）和伴有膝关节炎（210例）的SDD患者以LDD占比最高，分别为86.1%（348/404）和70.0%（147/210）；伴有韧带肥厚/骨化（2645例）的SDD患者以CDD占比最高，为79.9%（2114/2645）。伴有高血压及糖尿病的SDD患者占比分别为20.8%（4749/22951）和9.7%（2230/22951）。结论：SDD有着明显的人口学特征，在不同部位发病的人群特征不同。男性、50～54岁、办公室人员是CDD的高发人群；男性、农民是TDD的高发人群；<45岁的男性，特别是18～29岁的男性以及>45岁的女性是LDD的高发人群。此外，伴有骨质疏松或伴有膝关节炎是LDD的危险因素，伴有韧带肥厚/骨化是CDD的危险因素。针对上述高危人群进行有重点的干预和宣教可能是降低SDD发病率的重要措施。

英文摘要:

  【Abstract】 Objectives: To explore the correlation of the incidence and social characteristics in patients with spinal degenerative diseases(SDD), and to provide certain evidence for prevention, treatment and incidence control of the disease. Methods: Data between January 1, 2008 to December 31, 2014 were collected from electronic medical documents of the orthopedic department, including patients who suffered from SDD, treated by operation for the first time and aged 18 years old or over. Descriptive statistics and Chi-square test were used to analyze the correlation of social characteristics of patients（eg. age, gender, career, place of birth, nationality and comorbidities） and the degenerative spinal diseases. Results: Total number of included patients with SDD was 22951, including 12838(55.9%) male patients and 10113(44.1%) female patients. The average age was 52.4±11.6 years old(aged 18 to 86 years old). The number of patients with cervical degenerative spinal diseases(CDD) was 10941(47.7%); with thoracic degenerative spinal diseases(TDD) was 588(2.6%); with lumber degenerative spinal diseases(LDD) was 11422(49.8%). There were significant differences in gender, age, occupation and regional distribution of SDD in different parts of the patients(P＜0.001), and there was no significant difference in the distribution of nationality. In the patients with CDD, a higher percentage was in male, 50 to 54 years old people and office staff, when the gender, age and career of the patients were considered; in the patients with TDD, a higher percentage was in male and peasants, when the gender and career of the patients were considered; in the patients who were younger than 45 years old and with LDD, a higher percentage was in male as considering gender, especially in the patients aged 18 to 29 years old; however, in the patients who were older than 45 years old and with LDD, a higher percentage was in female as considering gender. Additionally, the number of patients who had or did not have comorbidities was 8160 or 14791. The comorbidities of osteoporosis and osteoarthritis of knee joint were common in patients who had LDD, with a percentage of 86.1%(348/404) and 70.0%(147/210); the comorbidity of hypertrophy/calficy of ligamentum was common in patients who had CDD, with a percentage of 79.9%(2114/2645). The rates of the comorbidities of hypertension and diabetes in patients who had SDD were 20.8%(4749/22951) and 9.7%(2230/22951), respectively. Conclusions: Social characteristics in SDD are significant and vary according to the area of degenerative spinal diseases. Risk population for CDD is male, 50 to 54 years old people and office staff; risk population for TDD is male and peasants; risk population for LDD is male younger than 45 years old, especially the 18 to 29 years old male patients, and female older than 45 years old. Additionally, osteoprosis and osteoarthritis of knee joint are risk factors for LDD, and hypertrophy/calficy of ligamentum is risk factors for CDD. Interventions and educations in these high risk populations are important to decrease the incidence of degenerative spinal diseases.