北京地区围绝经期妇女骨质疏松流行病学调查与分析

目的 :了解北京地区围绝经期妇女骨密度 (BMD)水平以及骨质疏松 (OP)的患病率 ,分析影响 OP的有关因素 ,评价 OP的单光子筛查方法。方法 :采用分层整群概率比率的方法在北京地区抽取 10个群体 ,对 2 4 2 9名 4 0～ 6 5岁围绝经期妇女进行问卷调查和 BMD测定。结果 :(1) OP患病率为 37.9%。 5 0岁以上各年龄组患病率明显高于 4 0岁组 (P<0 .0 0 1)。城市妇女 OP患病率明显高于农村妇女 (P<0 .0 0 1)。 (2 )绝经组 BMD均值为 0 .5 91± 0 .110 ,未绝经组 BMD均值为 0 .70 2± 0 .10 0 (P<0 .0 0 1)。(3)骨折发生率为 5 .9%。骨折好发部位依次为下肢、手腕、腰椎。 (4 )与 BMD呈显著正相关的因素有 :生育年龄、体重、喝牛奶、锻炼、居住地农村。呈显著负相关的因素有 :年龄、生育次数、哺乳时间、吸烟等。 (5 )单光子筛查方法的灵敏度为 83.3% ,特异度为70 .7%。结论 :围绝经期妇女 BMD变化的原因主要是受年龄、绝经因素的影响。预防 OP应提倡加强锻炼、不吸烟 ,妊娠期和哺乳期每日喝牛奶等。研究提示测量 BMD有助于预测骨折发生的危险性。单光子骨密度测定适于在患 OP的高危人群中作为筛查方法。

The epidemiological study of perimenopausal women with osteoporosis in Beijing

Objective:To know the bone mineral density (BMD) and osteoporosis(OP) condition of perimenopausal women in Beijing as well as relevant factors.Methods:Using the sampling method of stratified,clustering and proportional to size(PPS),10 clusters were selected from the areas of Beijing.2 429 women aged 40~65 years old from the selected clusters were interviewed and measured.Results:(1)The prevalence rate of osteoporosis was 37.9%.It was significant higher in more than 50 years old women than that of under 50 years old ones(P<0.001),significant higher in urban women than that in rural women(P<0.001).(2)The mean value of BMD in the group of menopause/non-menopause was 0.591±0.110/0.702±0.100 separately (P<0.001).(3)The bone fracture rate was 5.9%.The high risk parts of bone fracture were leg,carpus,and lumber vertebra in turn.(4)The positive relevant factors with BMD were childbirth age,weight,drinking milk,exercise,living in rural areas et al,the negative ones were age,procreative times ,breast feeding,smoking et al.(5) Sensitivity and specificity by the screening of single-photon absorptionmeter were 84.6% and 70.3%.Conclusion:The main BMD decreasing reasons of perimenopausal women are age and menopause.Exercise,not smoking and drinking milk everyday for maternal women are suggested to prevent OP.The measurement of bone density can be used to predict the risk of osteoporotic fracture.Single-photon absorptionmeter is fit for high risk women of OP.