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1.
目的研究老年膝关节骨关节病与生活方式有关的风险因素和居住环境对该病流行情况的影响,为其防治提供科学依据。方法 2008年6月至2009年3月调查北京市丰台区长辛店城乡部分地区长期居住、具有本地户口、60岁以上的居民1 507名。全部采取问卷调查、骨科基本查体和双膝关节的正侧位X线片检查方式进行,根据问卷内容确实有临床症状,且放射学X射线片显示Kellgren&Lawrence分级≥Ⅱ级的,排除继发性骨关节病后,可以确诊膝原发性骨关节病。采用多元逐步回归分析方法分析老年膝骨关节病的影响因素。结果符合条件的人数为851人(男266人,女585人),平均65.9岁。总患病率为38.1%,男25.6%,女43.9%;随年龄增长患病率增加;体重指数≥25 kg/m2,患病率明显增高;寒冷潮湿环境中患病率升高。结论女性、年龄、体质量指数及寒冷潮湿环境是老年膝骨关节病的主要暴露因素。  相似文献   

2.
目的调查沈阳市区老年女性膝骨关节炎(KOA)患者常见危险因素,为临床防治提供依据。方法选择2016年1月至2018年12月在本院就诊的老年女性膝骨关节炎患者169例,对照组选择同期在我院门诊体检健康老年女性155例,两组患者均接受了“膝骨关节炎常见危险因素问卷”调查。结果老年膝骨关节炎组的平均年龄、BMI、体力劳动者、膝骨关节炎家族史、吸烟指数、膝关节外伤史、缺乏锻炼、寒冷环境例数均显著多于对照组(P<0.01,P<0.05)。结论年龄偏大、肥胖、膝骨关节炎家族史、膝关节外伤史、吸烟、寒冷环境、缺乏锻炼都是沈阳市区老年女性膝骨关节炎患者常见危险因素。  相似文献   

3.
膝骨关节炎的流行病学调查   总被引:101,自引:1,他引:101  
对北京郊区一农村2063名成人进行了膝骨关节炎的流行病学调查,全部采取调查提问,回答有膝关节痛者799人(占38.7%),随机取有膝痛者311人及无膝痛者212人都照了X线膝相。前组有放射线下骨关节炎改变、从而可诊断为膝骨关节炎者79人,占有膝痛者中24.7%;后组无膝痛尚不能诊断为膝骨关节炎,但膝相示有骨关节炎改变者,也有54人(占25.5%)。两组有X线改变者皆随年龄增加而增多,60岁以上者前组占78%,后组占67%。所有阳性病人皆除外了其他可引起继发性骨关节炎的疾病。对退休干部100人进行了类似调查,全部都照了膝关节相,有骨关节炎X线改变者91人,其中有膝关节痛的51人中,可诊断为膝骨关节炎者49人,占有膝痛者中95。9%。作为各年龄组成人的一个代表性人群,农村523人拍膝关节片,膝骨关节炎患病率约为9.6%,以100名退休干部作为一代表性城市老年人群,膝骨关节炎患病率为49%。本调查中将无膝痛但有膝骨关节炎X线改变者不计为临床膝骨关节炎病例。  相似文献   

4.
社区45岁以上人群退行性膝关节病流行病学调查   总被引:8,自引:0,他引:8  
目的 了解广州社区45岁以上人群退行性膝关节病发生率及相关因素。方法 采用流行病学中的典型调查和横断面调查研究方法,对广州市人民街18个居委3010名45岁以上成人进行了膝关节炎的流行病学调查。全部采取调查提问,现场调查由经过培训的医生执行,随机抽取膝关节病史阳性者及阴性者各300名X线检查,由专家统一质量控制和回收表格,统计分析,最后由疼痛科及骨科专家进行专业分析。结果 回答膝关节病史阳性者650例(占21.5%),男性发病率为13.2%,女性发病率为28.3%,女性发病率明显高于同年龄组男性(χ^2=100.26,P〈0.01)。300例膝关节病史阳性者X线改变289例(占96.3%),300名膝关节病史阴性者X线改变172例(占57.3%),膝关节病史阳性者X线改变率较阴性者高(χ^2=128.18,P〈0.01),接受系统治疗者119例(占18.2%)。结论 广州社区退行性膝关节炎发病率低于国内外其他地区,女性发病率高于同年龄组男性,膝关节病史阳性者X光片改变率较阴性者高,超过80%的患者未接受系统治疗。  相似文献   

5.
太原市膝骨关节炎的流行病学研究   总被引:4,自引:1,他引:4  
目的探讨膝骨关节炎(OA)的相关危险因素,以提高膝OA的预防水平。方法参照亚太地区风湿病学会联合会社区控制风湿病规划《膝OA危险因素调查表》(草案),对太原市某社区2188名居住无电梯6层楼房10年以上的35—64岁居民进行调查。采用logistic回归分析,观察性别、年龄、体重指数、腰围、工龄、受教育程度、吸烟、宗教信仰等因素对膝OA的影响。结果太原市居民膝痛和膝OA患病率分别为13.6%和10、9%,显著高于南方城市汕头,OA患病率与北方城市北京相近;女性患病率显著高于男性(18,3%比8、7%和15.1%比6.3%),且有随年龄增加而升高的趋势。膝OA患病率在女性40岁以后、男性45岁以后升高更为显著。膝OA组体重指数显著大于非膝OA组。多因素logistic回归分析结果显示:年龄、性别、体重指数为膝OA的危险因素。不同楼层膝痛和膝OA患病率差异无统计学意义。结论地理位置、年龄、女性和超重(体重指数≥24kg/m^2)可能是膝OA的相关危险因素,未发现爬楼梯与膝OA有关联。中年人(尤其是女性)即应开始预防膝OA;控制体重、防止肥胖对预防膝OA有重要意义。  相似文献   

6.
目的:探讨云南省安宁市60岁及以上人群糖尿病患病情况及其影响因素。方法:本研究为横断面研究。于2019年9月至2020年1月间,用多阶段分层整群抽样法选取云南省安宁市57个自然村的60岁及以上人群,记录研究对象的年龄、民族、所在地区经济发展水平等,记录其身高、体重并计算体重指数(BMI),检测空腹血糖(FPG)、总胆固...  相似文献   

7.
目的 系统评价热敏灸在诊治膝骨关节炎的临床疗效.方法 采取计算机和人工的方法检索数据库,汇集热敏灸治疗膝骨关节炎的随机对照试验文献.按纳入的标准严格筛选后,并且对纳入的研究进行质量评价,对纳入研究的总有效率进行Meta分析.结果 本研究共纳入11篇随机对照试验研究文献,合计共578例.Meta分析结果显示:①热敏灸在诊...  相似文献   

8.
目的探讨吉安市老年膝骨关节炎患者运动锻炼自我管理行为的现状及其影响因素。方法选择江西省吉安市老年膝骨关节炎患者285例,首先应用关节炎生活质量测量量表对老年膝骨关节炎患者的生活质量进行评定,应用自我管理行为量表对老年膝骨关节炎患者运动锻炼自我管理行为的现状进行调查,同时分析影响患者运动锻炼自我管理行为的因素。结果吉安市老年膝骨关节炎患者总生活质量得分为(71.83±10.82)分,各维度得分均相对较低。老年膝骨关节炎患者每周的体能锻炼时间为(25.33±5.29)min/w,每周的耐力锻炼时间为:(133.15±26.31)min/w。老年膝骨关节炎患者体能锻炼的因素包括体重指数(BMI)、疼痛程度、重视程度、麦克马斯特骨关节炎(WOMAC)指数、每次疼痛持续天数、自我效能等。影响老年膝骨关节炎患者耐力锻炼的因素包括家庭住址、受教育程度及BMI等。结论吉安市老年膝骨关节炎患者的生活质量普遍较差,且老年膝骨关节炎患者运动锻炼自我管理的状况不容乐观,针对影响老年膝骨关节炎患者运动锻炼自我管理行为的因素实施干预措施是缓解患者病情、改善患者生活质量的关键。  相似文献   

9.
骨关节炎(OA)是指以软骨丢失及伴有关节周围骨反应为特点的一种滑膜关节病,是关节的一种慢性、多发性疾病,其中以膝OA最常见.多发生在中老年人,其临床表现主要为关节疼痛、僵直,且随病情加重可导致功能障碍,生活难以自理,严重影响其生活质量.膝OA治疗有药物、物理、中医针灸和外科手术治疗等多种方法.单独使用西药治疗副作用大,远期疗效差,而外科手术治疗费用高,病人往往难以接受,中医治疗以其副作用小,花费低为优点成为治疗膝OA的一种较好方法.本文回顾分析针灸、中药、玻璃酸钠关节腔内注射及综合治疗膝OA患者的疗效,为其临床治疗提供依据.  相似文献   

10.
膝症状性骨关节炎320例X线分析   总被引:7,自引:0,他引:7  
目的:探讨膝骨关节炎X线特点及临床意义。方法:临床就诊组206例,流行病学调查组114例,共476个病膝。摄常规正、侧位片,分析X线征象并作骨关节炎分级。结果:两组病膝胫股关节内侧部骨关节炎征象较外侧部显著,胫骨纵轴线与胫骨平台关节面切线的外侧交角(胫骨角)为92°±146°。就诊组病膝的X线改变(尤其髌股关节和髌上囊肿胀),较流行病学调查组明显。结论:膝胫股关节的骨关节炎主要发生在内侧部,可能与胫骨上端的内翻有关。膝关节炎X线改变的程度,尤其髌股关节和关节囊肿胀,与临床表现相关。  相似文献   

11.
Objectives A community-based survey on the prevalence of knee osteoarthritis (OA) and associated factors was carried out in Shanghai, Peoples Republic of China.Methods Of 2,305 registered residents 40 years of age, 2,093 were examined by interview and questionnaire. One hundred ninety knee pain-positive and 510 knee pain-negative subjects received radiography.Results Radiographic knee OA (RKOA) was found in 72.1% (137/190) of symptomatic and 41.6% (212/510) of asymptomatic subjects (SKOA and AsKOA, respectively). The estimated prevalences of symptomatic and asymptomatic knee OA in the community were 7.2% and 37.4%, respectively. Women had higher SKOA prevalence than men (9.8% vs 3.7%, P<0.01). Compared with Caucasians, the urban Shanghai population had a higher prevalence of tibiofemoral joint OA.Conclusions There was a higher proportion of SKOA than AsKOA (72.1% vs 41.6%), and SKOA was significantly more associated with disability (81.0% vs 26.9%, P<0.01). The prevalence of SKOA increased with age, from 1.3% in the 40–49-year-old age group to 13.2% in the 70+ group. Age, body mass index, and female gender were associated risk factors for knee OA.  相似文献   

12.
IntroductionHand osteoarthritis (OA) is a highly prevalent disease with a significant physical and social burden. Thus we decided to find out prevalence of hand OA in the patients above 40 year of age who presented to us with either hand symptoms or knee OA.MethodsPostero-anterior hand radiographs were taken of both hands to confirm the diagnosis of hand OA. Fifteen joints were evaluated for the presence of osteophytes, joint space narrowing, sclerosis, and cysts. 358 patients attending Rheumatology OPD of two tertiary care centers in Eastern India in one year participated in study.ResultsNinety nine (27.65%) of 358 subjects had radiological hand OA. Among the 222 patients with knee OA 90 (40.5%) patients had hand OA. Nine (6.6%) of 136 patients with hand symptoms alone had hand OA. Overall 212 (59.21%) of 358 patients had symptoms in hand joints and of them 49 (23.2%) patients had hand OA positive. Female sex, older age, BMI >25, family history of OA or diabetes mellitus increased the risk of radiological hand OA. Knee OA increased the risk of hand OA both symptomatic and asymptomatic.ConclusionHand OA is common and a good quality X ray of hand is an initial investigation to diagnose hand OA. Presence of Knee OA increases risk of hand OA.  相似文献   

13.
Aim of the workObesity and the related metabolic syndrome cluster of cardiovascular risk factors have been associated with chronic kidney disease (CKD). Patients with knee osteoarthritis (OA) are frequently obese and due to the combined effects of obesity and the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs); they may represent a high risk group for renal dysfunction. We aimed to detect preclinical renal involvement in obese patients with knee OA.Patients and methodsForty patients with knee OA and a body mass index (BMI) ? 30 (mean age 43.5 ± 3.7 years) not on chronic NSAID use and forty age and sex matched non-obese controls were enrolled in this study. For all subjects anthropometric measures were taken. Laboratory assessment included fasting blood sugar, serum triglycerides, high density lipoprotein cholesterol (HDL), serum uric acid, urea, creatinine and microalbuminuria assay. For patients with knee OA, knee radiographs were done and the disease severity was assessed according to Kellgren–Lawrence (K–L) scale. Tc-99 m DTPA was used for the measurement of the glomerular filtration rate (GFR) and the results were classified into normal and CKD according to Kidney–Dialysis Outcomes and Quality Initiative stages.ResultsAmong the patients’ group, 26/40 (65%) had CKD compared to 12/40 (30%) subjects among the controls (P = 0.001). GFR correlated positively with HDL (r = 0.4; P = 0.02) and inversely with microalbuminuria and the severity of knee OA (r = ?0.4; P = 0.02 for each).ConclusionsObese patients with knee OA represent a high risk group for renal dysfunction.  相似文献   

14.
Objectives: Morphological features of the distal femur and proximal tibia associated with cartilage degeneration are unknown. This study aimed to elucidate local anatomical parameters of the knee which correlate with articular cartilage degeneration using MRI T1ρ mapping.

Methods: This study involved 200 subjects with knee pain (mean age, 48.7 years; range, 14–80 years) with no severe osteoarthritic changes on plain X-ray. T1ρ values were measured in the regions of interest on the surface layer of the cartilage on mid-coronal images of the femorotibial joint. Assessment of medial and lateral posterior tibial slope (MTS, LTS) and medial and lateral femoral condylar offset ratio (MFCOR, LFCOR) was performed using sagittal proton density-weighted imaging. Morphological assessment of posterior root and horn of menisci was also performed according to a modified Whole Organ Magnetic Resonance Imaging Score (WORMS) of the knee.

Results: Multiple regression analysis revealed that a decrease in MTS was associated with increased T1ρ values in the medial tibia, independent of age, osteoarthritic changes on plain X-ray, femur-tibia angle (FTA), and posterior medial meniscal lesions.

Conclusions: Shallow MTS correlates with cartilage degeneration in symptomatic patients. This parameter could help in understanding the etiology of osteoarthritis in the early stage. Future kinematic studies will be needed to confirm our findings.  相似文献   


15.
目的 探究悬吊技术联合Mulligan手法用于膝骨关节炎老年人运动后膝关节疼痛康复的效果.方法 选取84例单侧膝关节运动后疼痛的膝骨关节炎老年患者,依据随机数字表法分为观察组和对照组,各42例.对照组给予常规物理治疗与悬吊训练治疗,观察组在对照组基础上给予Mulligan技术治疗.比较两组治疗开始前与治疗后视觉模拟评分(VAS)疼痛评分、QOL-BREF评分、LEFS下肢功能评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力.结果 两组治疗后VAS评分明显降低(P<0.05),且观察组VAS评分明显低于对照组(P<0.05).两组治疗后QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力较治疗前明显提高(P<0.05),且治疗后观察组QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力明显高于对照组(P<0.05).结论 对于膝关节运动后疼痛的膝骨关节炎老年患者,悬吊技术联合Mulligan手法,能有效缓解膝关节疼痛、促进膝关节功能恢复,提高患者生活质量.  相似文献   

16.
Aim of the workCentral sensitization (CS) is a nervous system disorder associated with chronic pain. This study aimed to quantify pain and evaluate conditioned pain modulation (CPM) and CS in knee osteoarthritis (KOA) patients with chronic pain.Patients and methodsThe study included 50 patients with primary KOA having chronic pain and 50 matched controls. The following assessment tools were used: visual analog scale (VAS)-pain, Western Ontario and McMaster Universities (WOMAC), pain DETECT questionnaire (PD-Q), and central sensitization inventory (CSI). Also, pressure pain threshold (PPT), electrical sensory threshold (EST), and electrical pain threshold (EPT) were assessed at both knees and remote sites. CPM was assessed using the submaximal effort tourniquet method, and the CPM ratio was measured (pre-to-post PPT).ResultsThe patients' mean age was 49.6 ± 9.7 years, 32 females and 18 males (F:M 1.2:1), and disease duration of 7.4 ± 3.6 years. Patients had a significantly higher CPM ratio (1.1 ± 0.21), PD-Q score (20.1 ± 9.1), CSI score (48.8 ± 21.4) compared to the control (0.9 ± 0.07; 8.3 ± 3.9 and 25.5 ± 9.4 respectively; p < 0.0001) and had a lower EPT and PPT in both knees and remote sites (p < 0.0001). CPM was significantly correlated with VAS-pain, WOMAC, CSI, PD-Q and inversely with EPT and PPT at both knees and remote sites and with EST at the right knee (p < 0.0001 each). CPM, PD-Q, and left knee EPT were significant predictors of CS tested with CSI (p < 0.0001, p < 0.0001, and p = 0.004, respectively).ConclusionThere is evidence of CS in KOA patients having chronic pain, and CPM and PD-Q can predict CS.  相似文献   

17.
To investigate if spa water is superior to tap water (TW) in relieving the symptoms of pain, joint motion, life quality in knee osteoarthritis (KOA) patients. In this randomized placebo-controlled trial, 52 patients with KOA were followed in two groups. In group I (n = 27), patients were treated in the pool full of spa water at 37°C for 20 min a day, 5 days a week, for a period of 2 weeks. In group II (n = 25), the same protocol was used but spa water was replaced by TW heated to 37°C. Patients in both groups were given a home-based standardized exercise program. Evaluation parameters were pain (pVAS), tenderness score (TS), 50-ft walking duration, quadriceps muscle strength (QMS), active flexion degree (AFD), WOMAC OA index, and Nottingham Health Profile (NHP). The first evaluation was done after the informed consent was obtained. Second and third evaluations were done at the 2nd and 12th week. PVAS, 50-ft walking duration, AFD, TS, WOMAC, and NHP variables improved in group I. Same variables except QMS improved also in group II. Comparison of the groups just after treatment showed that only pVAS (P = 0.015), NHP pain score (P = 0.020), and TS (P = 0.002) differed significantly in favor of group I at the 2nd or 12th week. Both of the thermal treatment modalities were found to be effective in the management of the clinical symptoms and quality of life in KOA patients. However, pain and tenderness improved statistically better with balneotherapy. There were no significant differences between the groups for the other variables.  相似文献   

18.
OBJECTIVES: Different prevalences of generalised osteoarthritis (GOA) in patients with knee and hip OA have been reported. The aim of this investigation was to evaluate radiographic and clinical patterns of disease in a hospital based population of patient subgroups with advanced hip and knee OA and to compare the prevalence of GOA in patients with hip or knee OA, taking potential confounding factors into account. METHODS: 420 patients with hip OA and 389 patients with knee OA scheduled for unilateral total joint replacement in four hospitals underwent radiographic analysis of ipsilateral and contralateral hip or knee joint and both hands in addition to a standardised interview and clinical examination. According to the severity of radiographic changes in the contralateral joints (using Kellgren-Lawrence > or = grade 2 as case definition) participants were classified as having either unilateral or bilateral OA. If radiographic changes of two joint groups of the hands (first carpometacarpal joint and proximal/distal interphalangeal joints defined as two separate joint groups) were present, patients were categorised as having GOA. RESULTS: Patients with hip OA were younger (mean age 60.4 years) and less likely to be female (52.4%) than patients with knee OA (66.3 years and 72.5% respectively). Intensity of pain and functional impairment at hospital admission was similar in both groups, while patients with knee OA had a longer symptom duration (median 10 years) compared with patients with hip OA (5 years). In 41.7% of patients with hip OA and 33.4% of patients with knee OA an underlying pathological condition could be observed in the replaced joint, which allowed a classification as secondary OA. Some 82.1% of patients with hip and 87.4% of patients with knee OA had radiographic changes in their contralateral joints (bilateral disease). The prevalence of GOA increased with age and was higher in female patients. GOA was observed more often in patients with knee OA than in patients with hip OA (34.9% versus 19.3%; OR = 2.24; 95% CI: 1.56, 3.21). Adjustment for the different age and sex distribution in both patient groups, however, takes away most of the difference (OR = 1.32; 95% CI: 0.89, 1.96). CONCLUSION: The crude results confirm previous reports as well as the clinical impression of GOA being more prevalent in patients with advanced knee OA than in patients with advanced hip OA. However, these different patterns might be attributed to a large part to a different distribution of age and sex in these hospital based populations.  相似文献   

19.
目的 观察芪防膝痹方治疗膝骨关节病的临床疗效.方法 将96例患者按随机原则分为治疗组48例、对照组48例.治疗组BID口服芪防膝痹方水煎剂150 mL,对照组QD口服塞来昔布胶囊200 mg.治疗4w后,分别以Lequesne M的膝骨关节病临床评估指数打分表对治疗前后病情严重程度打分,并进行统计分析.结果 治疗组和对照组在疗效上差异无统计学意义(P>0.05),治疗组LequesneM表中的各项目评分与对照组差异无统计学意义(P>0.05).芪防膝痹方对气滞血瘀型、肝肾不足型的疗效优于风寒湿型[(89.40±9.23)vs (80.20±13.62),P<0.05];[(88.70±6.26)vs (80.20±13.62),P<0.05],对临床中期患者的效果优于早、晚期[(92.57±2.59) vs (84.63±8.01),P<0.05];[(92.57±2.59)vs (83.00±13.51),P<0.05],对X线Ⅱ期患者的效果优于Ⅰ、Ⅲ期[(92.75±2.49)vs(84.63±8.01),P<0.05];[(92.75±2.49)vs (81.63±13.73),P<0.05].结论 芪防膝痹方在临床疗效上与塞来昔布相当,在某些期或某些功能的改善上优于塞来昔布,适合临床推广.  相似文献   

20.
BackgroundPain in osteoarthritis (OA) primarily results from tissue damage but its' intensity does not essentially parallel the extent of joint destruction or presence of active inflammation, thus suggesting the likely involvement of a central component. The mid-anterior cingulate cortex (mACC) has an important role in pain perception, intensity and progression. In OA, low mACC γ-aminobutyric acid (GABA) was associated with high pain suggesting a role of prefrontal disinhibition. Aim of the work: To investigate the role of mACC (GABA) levels in chronic knee OA (KOA) pain and determine if magnetic resonance spectroscopy (MRS) brain neurotransmitters can serve as potential biomarkers. Patients and methods: Forty-five patients with primary KOA (M/F:33/12; age:57 ± 6 years) along with 15 matched controls were recruited. Pain was assessed using Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS) and Western Ontario McMaster Osteoarthritis (WOMAC) questionnaire. mACC (GABA) was assessed and brain MRS neurotransmitters analysed including glutamate (Glx); N-acetylaspartate (NAA), total choline (tCho) and myo-inositol. Results: MRS analysis demonstrated no metabolite differences between controls and KOA patients in GABA, Glx, NAA and tCho. Myo-inositol:Glx ratio was significantly higher in patients (1.47 ± 0.37 vs 1.1 ± 0.29; p < 0.001). mACC (GABA) negatively correlated with VAS (r = −0.86, p < 0001), PCS (r = −0.94, p < 0001) and WOMAC (r = −0.96, p < 0001) in KOA patients. Myo-inositol:Glx significantly correlated with the age (r = 0.31, p < 0.038), disease duration (r = 0.61, p < 0.0001), VAS (r = 0.4, p < 0.02), PCS (r = 0.48, p < 0.001) and WOMAC (r = 0.53, p < 0.0001). Conclusions: This work confirms the importance of mACC in central sensitization of pain and highlights a promising role of the inflammatory neurotransmitter GABA and myo-inositol:Glx ratio as mechanistic biomarkers of chronic KOA pain.  相似文献   

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