急性脑梗死后骨折危险因素研究

目的:研究急性脑梗死后骨折的危险因素。方法:采用电话或信函方式对在研究期间出院的所有急性脑梗死患者发病后随访1年,采用非条件logistic回归分析方法研究患者性别、年龄、肢体偏瘫程度、高血压、糖尿病、高脂血症病史、口服抗凝药华法林、口服预防骨质疏松药物对急性脑梗死患者发病后骨折发生率的影响。结果:符合研究标准的1 546例患者中男854例,女692例,年龄34～82(58±11)岁。发病12个月内共发生32例骨折(2.07%)。女性[OR 2.0(95%CI 1.3,3.9)]、年龄>60岁[OR 1.4(95%CI 1.2,1.8)]、口服华法林[OR 5.6,(95%CI 2.5,7.9)]的患者,在急性脑梗死后较易发生骨折。口服双磷酸盐,维生素D及钙等抗骨质疏松药物能减少脑梗死后骨折的发生[OR 0.7,(95%CI 0.4,0.9)]。患者既往高血压[OR 1.0,(95%CI 0.3,1.2)]、糖尿病[OR 1.1,(95%CI 0.6,1.4)]、高脂血症[OR 0.9,(95%CI 0.7,2.5)]与骨折的发生无明显相关。结论:高龄、女性、口服华法林是急性脑梗死后骨折的危险因素,而口服预防骨质疏松药物能减少急性脑梗死后骨折的发生。

Risks of Fractures after Acute Cerebral Infarction

Objective:To study the Risks of fractures after acute cerebral infarction.Methods:Using telephone or correspondence to follow-up 1 546 acute stroke patients for 1 year.To investigate the Risks of fractures.Results:A total of 32 fractures were recorded for 1 546(2.07%) patients in 1 year.Patients of women,aged>60 years,oraling warfarin are prone to fracture after acute cerebral infarction.Oraling anti-osteoporosis drugs such as bisphosphonate,vitamin D and calcium,can reduce the incidence of fracture after acute cerebral infarction.Hypertension,diabetes and hyperlipidemia have no significant correlations with incidence of fractures after acute cerebral infarction.Conclusion:Patients of women,aged>60 years,oraling warfarin appear to be at risk for fractures after cerebral infarction.Oraling anti-osteoporosis drugs can reduce the incidence of fracture after acute cerebral infarction.