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[1]杜丹,付佳,楊曦,等.膝骨關(guān)節(jié)炎患者膝內(nèi)翻畸形的影響因素分析[J].中醫(yī)正骨,2022,34(11):32-36，47.
　DU Dan,FU Jia,YANG Xi,et al.Analysis of factors influencing genu varum deformity in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(11):32-36，47.
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膝骨關(guān)節(jié)炎患者膝內(nèi)翻畸形的影響因素分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年11期
頁(yè)碼:
32-36，47
欄目:
調(diào)查研究
出版日期:
2022-11-11

文章信息/Info

Title:
Analysis of factors influencing genu varum deformity in patients with knee osteoarthritis
作者:
杜丹; 付佳; 楊曦; 馮琳; 張揮武
(四川省骨科醫(yī)院,四川 成都 610041)
Author(s):
DU Dan; FU Jia; YANG Xi; FENG Lin; ZHANG Huiwu
Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  膝內(nèi)翻;  Logistic模型;  危險(xiǎn)因素;  保護(hù)性因素;  因素分析; 統(tǒng)計(jì)學(xué)
Keywords:
osteoarthritis; knee;  genu varum;  logistic models;  risk factors;  protective factors;  factor analysis; statistical
摘要:
目的:探討膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)患者膝內(nèi)翻畸形的影響因素。方法:納入KOA患者237例,拍攝患者負(fù)重正位雙下肢X線片,測(cè)量雙下肢膝內(nèi)翻角。兩側(cè)膝內(nèi)翻角不一致時(shí),記錄角度較大者。從病歷系統(tǒng)中提取患者的性別、年齡、文化程度、體質(zhì)量指數(shù)、Kellgren-Lawrence影像分級(jí)、KOA家族史、膝關(guān)節(jié)外傷史、病程等信息。采用美國(guó)特種外科醫(yī)院(Hospital for Special Surgery,HSS)膝關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)評(píng)價(jià)患者膝關(guān)節(jié)運(yùn)動(dòng)功能,記錄HSS膝關(guān)節(jié)評(píng)分; 設(shè)計(jì)調(diào)查問卷獲取患者工作姿勢(shì)、工作類型、排便姿勢(shì)、爬山頻次、飲酒史、吸煙史、是否進(jìn)行規(guī)律的伸展運(yùn)動(dòng)、通勤方式、住房類型、有無服用鈣補(bǔ)充劑及水果、蔬菜、肉類攝入量等信息。根據(jù)膝內(nèi)翻角大小將納入的患者分為膝內(nèi)翻角正常組(膝內(nèi)翻角<10°)和膝內(nèi)翻畸形組(膝內(nèi)翻角≥10°)。先對(duì)2組患者的相關(guān)信息進(jìn)行單因素對(duì)比分析,然后對(duì)其中組間差異有統(tǒng)計(jì)學(xué)意義的因素進(jìn)行多因素Logistic回歸分析。結(jié)果:問卷調(diào)查收回有效問卷232份,最終納入KOA患者232例。膝內(nèi)翻角正常組121例,膝內(nèi)翻畸形組111例。2組患者性別、年齡、體質(zhì)量指數(shù)、Kellgren-Lawrence影像分級(jí)、病程、HSS膝關(guān)節(jié)評(píng)分、工作姿勢(shì)、工作類型、排便姿勢(shì)、爬山頻次、是否進(jìn)行規(guī)律的伸展運(yùn)動(dòng)、通勤方式、住房類型、有無服用鈣補(bǔ)充劑的比較,組間差異均有統(tǒng)計(jì)學(xué)意義(χ2=5.033,P=0.025; t=-3.197,P=0.002; t=-4.487,P=0.000; χ2=5.426,P=0.020; t=-6.454,P=0.000; t=3.715,P=0.000; χ2=5.320,P=0.021; χ2=5.772,P=0.016; χ2=5.188,P=0.023; χ2=4.566,P=0.033; χ2=5.110,P=0.024; χ2=6.718,P=0.035; χ2=13.113,P=0.001; χ2=5.994,P=0.014); 2組患者文化程度、KOA家族史、膝關(guān)節(jié)外傷史、飲酒史、吸煙史、水果攝入量、蔬菜攝入量、肉類攝入量的比較,組間差異均無統(tǒng)計(jì)學(xué)意義(χ2=0.114,P=0.736; χ2=0.983,P=0.321; χ2=2.958,P=0.085; χ2=1.662,P=0.197; χ2=0.145,P=0.703; χ2=0.982,P=0.322; χ2=1.359,P=0.244; χ2=0.145,P=0.703)。Logistic回歸分析結(jié)果顯示,年齡、體質(zhì)量指數(shù)、Kellgren-Lawrence影像分級(jí)、工作姿勢(shì)、排便姿勢(shì)、爬山頻次、不進(jìn)行規(guī)律的伸展運(yùn)動(dòng)、通勤方式(步行)、住房類型(無電梯且4樓及以上)均是KOA患者膝內(nèi)翻畸形的危險(xiǎn)因素(β=0.375,P=0.031,OR=1.455; β=0.428,P=0.010,OR=1.534; β=0.501,P=0.007,OR=1.650; β=0.481,P=0.008,OR=1.618; β=0.349,P=0.039,OR=1.418; β=0.382,P=0.048,OR=1.465; β=0.391,P=0.037,OR=1.478; β=0.406,P=0.013,OR=1.501; β=0.413,P=0.001,OR=1.511),HSS膝關(guān)節(jié)評(píng)分是KOA患者膝內(nèi)翻畸形的保護(hù)因素(β=-0.513,P=0.005,OR=0.599)。結(jié)論:年齡、體質(zhì)量指數(shù)、Kellgren-Lawrence影像分級(jí)、工作姿勢(shì)、排便姿勢(shì)、爬山頻次、不進(jìn)行規(guī)律的伸展運(yùn)動(dòng)、通勤方式(步行)、住房類型(無電梯且4樓及以上)均是KOA患者膝內(nèi)翻畸形的危險(xiǎn)因素,HSS膝關(guān)節(jié)評(píng)分是KOA患者膝內(nèi)翻畸形的保護(hù)因素。
Abstract:
Objective:To investigate the factors influencing genu varum deformity in patients with knee osteoarthritis(KOA).Methods:Two hundred and thirty-seven KOA patients were enrolled in the study,and their weight-bearing anteroposterior X-ray films of lower limbs were taken for measuring the genu varum angles.The larger angle was recorded when the angles of genu varum were inconsistent between the 2 sides.The information about gender,age,education level,body mass index(BMI),Kellgren-Lawrence imaging classification,KOA family medical history,knee trauma history and disease course was extracted from the electronic medical record system.The knee motor function was evaluated by using the Hospital for Special Surgery(HSS)scoring criterion,and the HSS knee score was recorded.Moreover,a questionnaire was designed to obtain the patients' information such as working posture,working type,defecation posture,mountain-climbing frequency,drinking history,smoking history,doing or not doing regular stretching exercise,commuting mode,housing type,taking or not taking calcium supplements,fruit,vegetable and meat.The patients were divided into normal genu varum angle group(genu varum angle of <10 degrees)and genu varum deformity group(genu varum angle of ≥10 degrees).The single-factor comparative analysis was performed on the relevant information of patients in the 2 groups,followed by multi-factor logistic regression analysis on the factors with statistically significant differences between the 2 groups.Results:Two hundred and thirty-two valid questionnaires were collected,and 232 KOA patients were included in the final analysis,121 cases in normal genu varum angle group and 111 cases in genu varum deformity group.The information about gender,age,BMI,Kellgren-Lawrence imaging classification,disease course,HSS knee score,working posture,working type,defecation posture,mountain-climbing frequency,regular stretching exercise,commuting mode,housing type and taking calcium supplements was compared between the 2 groups,and the results revealed that the differences were statistically significant(χ2=5.033,P=0.025; t=-3.197,P=0.002; t=-4.487,P=0.000; χ2=5.426,P=0.020; t=-6.454,P=0.000; t=3.715,P=0.000; χ2=5.320,P=0.021; χ2=5.772,P=0.016; χ2=5.188,P=0.023; χ2=4.566,P=0.033; χ2=5.110,P=0.024; χ2=6.718,P=0.035; χ2=13.113,P=0.001; χ2=5.994,P=0.014),while there were no statistical differences in education level,KOA family medical history,knee trauma history,drinking history,smoking history as well as the intake of fruit,vegetable and meat between the 2 groups(χ2=0.114,P=0.736; χ2=0.983,P=0.321; χ2=2.958,P=0.085; χ2=1.662,P=0.197; χ2=0.145,P=0.703; χ2=0.982,P=0.322; χ2=1.359,P=0.244; χ2=0.145,P=0.703).The results of logistic regression analysis showed that the age,BMI,Kellgren-Lawrence imaging classification,working posture,defecation posture,mountain-climbing frequency,lack of regular stretching exercise,commuting mode(walking)and housing type(walk-up and the 4th floor or above)were the risk factors for genu varum deformity in KOA patients(β=0.375,P=0.031,OR=1.455; β=0.428,P=0.010,OR=1.534; β=0.501,P=0.007,OR=1.650; β=0.481,P=0.008,OR=1.618; β=0.349,P=0.039,OR=1.418; β=0.382,P=0.048,OR=1.465; β=0.391,P=0.037,OR=1.478; β=0.406,P=0.013,OR=1.501; β=0.413,P=0.001,OR=1.511),whereas the HSS knee score was the protective factor for genu varum deformity in KOA patients(β=-0.513,P=0.005,OR=0.599).Conclusion:The age,BMI,Kellgren-Lawrence imaging classification,working posture,defecation posture,mountain-climbing frequency,lack of regular stretching exercise,commuting mode(walking)and housing type(walk-up and the 4th floor or above)are the risk factors,whereas the HSS knee score is the protective factor for genu varum deformity in KOA patients.

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備注/Memo

備注/Memo:
基金項(xiàng)目:四川省科技計(jì)劃項(xiàng)目(2019YFS0446) 通訊作者:張揮武 E-mail:[email protected]
更新日期/Last Update: 1900-01-01