北京城区老年人膝、髋和手骨关节炎的患病率及其与美国白人患病率的比较研究

目的 采用与国际上一致的研究设计和诊断标准，调查北京老年人膝、髋和手骨关节炎(OA)患病率并与美国的白人资料进行比较。方法 对北京市城区人群进行抽样调查，对象为60岁以上的北京老年男女居民，知情同意后均进行人户调查及关节放射学检查。入户调查内容包括病史、职业史、关节病史、关节症状史、骨折史、药物史、体力劳动情况、手指动作、生活质量、生活方式、女性生育史及一般人口学资料。关节放射学检查包括双膝关节X线骨盆片及双手平片。研究方法及OA诊断标准均与美国Fmnmingham骨关节研究一致。结果 共有1012名男性和1507名女性接受了检查。北京老年妇女膝关节放射学OA的患病率高达46．6％，临床OA的患病率为15．4％，高于同年龄的美国妇女。北京男性老人膝关节放射学OA和临床OA的患病率分别为27．6％和7．1％，与美国男性近似。北京男女老人髋关节放射学OA的患病率仅为0．4％～0．8％，明显低于美国人。北京老年男女手关节放射学OA的患病率分别为44．5％和47．0％。和美国资料比较，北京老人手关节OA的患病率较低。结论与美国人比较，北京老年人手和髋关节OA患病率相对较低，但膝关节OA患病率极高，影响着千百万老人的健康和生活质量。

High prevalence of knee,but not hip or hand osteoarthritis in Beijing elders: comparison with data of Caucasian in United States

Objective To investigate the prevalence of knee, hip and hand osteoarthritis (OA) in the elderly of Beijing and to compare the prevalence of OA between the Beijing elders and the elderly US Caucasians. Methods Using the same standardized instruments and protocol as those in the Framingham Ostoarthritis Study, home interview, clinical examination and radiography were conducted among 1 012 males and 1507 females, all aged 60 and over, on 4 central districts of Beijing with informed consent. The data of survey were compared with those of the corresponding US study. Results The prevalence of radiographic and symptomatic knee osteoarthritis was 42.8% and 15.4% respectively among the women aged 60 and over in Beijing, higher than those in Caucasian women of the same age. The prevalence of radiographic and symptomatic knee osteoarthritis were 27.6% and 7.1% respectively among the men aged 60 and over in Beijing, similar to those in the Caucasian men of the same age. The prevalence of radiographic hand osteoarthritis among the Beijing men and women aged 60 and over were 44.5% and 47.0% respectively, lower than those among the contemporary Caucasian in US. The prevalence of hip OA among the men and women aged 60 and over were only 0.4% and 0.6%, significantly lower than those among the contemporary Caucasians in US. Conclusion Compared to the Caucasian contemporaries, fewer Beijing elderly suffer from hand and hip osteoarthritis. However, knee osteoarthritis is much more prevalent.