發(fā)布時(shí)間：2018-03-08 10:20

  本文選題：云南省麗江市納西族　切入點(diǎn)：跟骨定量超聲　出處：《昆明醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：1.測(cè)定云南省麗江納西族人群跟骨定量超聲參數(shù),創(chuàng)建跟骨超聲骨量數(shù)據(jù)庫(kù)。2.探討云南省麗江地域納西族骨質(zhì)疏松癥的發(fā)病率和危險(xiǎn)因素。3.測(cè)定云南省麗江地域納西族人群血清骨代四項(xiàng)謝標(biāo)志物,了解其變化規(guī)律。方法：采用整群抽樣法,抽取云南省麗江市納西族人口102例,年齡40～90歲,其中男性42人,女性60人,并按10歲區(qū)間劃分為一年齡段,將人群分為五組。上述每組人群均進(jìn)行跟骨定量超聲檢測(cè),基本體征測(cè)量,骨質(zhì)疏松相關(guān)要素問(wèn)卷調(diào)查；用ELISA法檢測(cè)血清骨代謝物標(biāo)志(25-(OH)D、PTH、BGP、CT),對(duì)調(diào)查結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：1.云南省麗江市納西族被調(diào)查人群BMD男女性均于45-50歲達(dá)到峰值骨量,峰值骨量高于全國(guó)其他地域,男女性峰值骨量無(wú)統(tǒng)計(jì)學(xué)差異性,以后隨著年齡的增長(zhǎng)而降低,且女性下降速率較男性快,以50歲最明顯。跟骨定量超聲SI,跟骨T值,跟骨BMD值,男性以45～52歲最高,女性以40～49歲最高,之后均迅速下降,男女性均于80歲以后骨量達(dá)到最低。其中,女性骨量降低較快的時(shí)間段為絕經(jīng)期后3-5年,說(shuō)明女性骨質(zhì)疏松與絕經(jīng)密切相關(guān),絕經(jīng)后女性骨量丟失較絕經(jīng)前多。2.人群身高、體重、年齡、腰圍、臀圍、BMI等與跟骨定量超聲T值及OSTA有相關(guān)性,呈現(xiàn)明顯的增齡性改變；吸煙,飲酒者骨密度顯著低于不吸煙者,骨質(zhì)疏松癥與飲酒量呈正相關(guān)關(guān)系；環(huán)境因素是重要因素,日照時(shí)間、勞動(dòng)量、飲食生活與人群骨密度高低密切相關(guān)。3.共檢測(cè)云南省麗江市納西族人群102人,按照診斷標(biāo)準(zhǔn),患病人數(shù)為5人,其中男性總?cè)藬?shù)1人患病4人,女性總?cè)藬?shù)60人,患病4人；總發(fā)病率為4.9%,男性發(fā)病率2.4%,女性發(fā)病率6.7%。隨著年齡的增加發(fā)病率升高,71-80歲年齡組發(fā)病率最高,為20.0%,差異有顯著性。40-50歲,50-60歲,60-70歲年齡組發(fā)病率為0。70-80歲年齡組女性發(fā)病率高于男性,差異無(wú)顯著性。4.云南省麗江市納西族被調(diào)查人群血清25-(OH)D值與年齡成負(fù)相關(guān),血清PTH與年齡成正相關(guān)。BGP、CT與年齡無(wú)相關(guān)性。有可能說(shuō)明云南省麗江市納西族人群隨著年齡的增加,骨質(zhì)疏松風(fēng)險(xiǎn)增加。結(jié)論：1.云南省麗江市納西族,被調(diào)查人群骨質(zhì)疏松發(fā)病率,低于全國(guó)其他地域,峰值骨量可能高于全國(guó)其他地域。2.人群身高、體重、年齡、腰圍、臀圍、BMI等與跟骨定量超聲T值及OSTA有相關(guān)性,呈現(xiàn)明顯的增齡性改變；吸煙,飲酒者骨密度顯著低于不吸煙者,骨質(zhì)疏松癥與飲酒量呈正相關(guān)關(guān)系；環(huán)境因素是重要因素,日照時(shí)間、勞動(dòng)量、飲食生活與人群骨密度高低密切相關(guān)。3.云南省麗江市納西族被調(diào)查人群,骨質(zhì)疏松發(fā)病率隨年齡的增加而逐年增加,男女性均以70-80歲年齡組發(fā)病率最多。這與年齡增長(zhǎng),機(jī)體功能減退,女性以絕經(jīng)后雌激素水平下降,男性以勞動(dòng)量下降等因素有關(guān)。4.有可能說(shuō)明云南省麗江市納西族人群隨著年齡的增加,骨質(zhì)疏松風(fēng)險(xiǎn)增加。
[Abstract]:Objective 1. To determine the quantitative ultrasonic parameters of calcaneus in Naxi nationality of Lijiang, Yunnan Province. To explore the incidence and risk factors of osteoporosis in Naxi nationality in Lijiang area of Yunnan Province. 3. To determine the four markers of bone replacement in serum of Naxi nationality in Lijiang area of Yunnan Province. Methods: 102 Naxi population of Lijiang City, Yunnan Province were selected by cluster sampling method. The population was 40 ~ 90 years old, including 42 males and 60 females, and was divided into one age group according to the age range of 10 years. The population was divided into five groups. Each group was examined by quantitative ultrasound of calcaneus, basic signs, osteoporosis related factors questionnaire; The ELISA method was used to detect the serum bone metabolite marker 25-OHH, PTHH, BGP, and the results were statistically analyzed. Results: 1. The peak bone mass of BMD was reached between 45 and 50 years old in Naxi nationality in Lijiang, Yunnan Province, and the peak bone mass was higher than that in other regions of China. There was no statistical difference in peak bone mass between men and women, and the rate of decline was faster in women than in men, especially in 50 years old. Calcaneal quantitative ultrasound, calcaneal T value, calcaneal BMD value were the highest in male patients at 4552 years old. The female bone mass was the highest in 40 or 49 years old, then declined rapidly, and the bone mass of both men and women reached the lowest after 80 years old. The period of female bone mass decrease was 3-5 years after menopause, indicating that female osteoporosis is closely related to menopause. The loss of bone mass in postmenopausal women was higher than that before menopause. The height, weight, age, waist circumference and hip circumference were correlated with calcaneal quantitative ultrasound T value and OSTA. Bone mineral density (BMD) of drinkers was significantly lower than that of non-smokers, osteoporosis was positively correlated with alcohol consumption, environmental factors were important factors, sunshine time, labor volume, A total of 102 Naxi people in Lijiang City, Yunnan Province were detected. According to the diagnostic criteria, the number of patients was 5, of which 4 were male, 60 were female and 4 were sick. With the increase of age, the incidence rate of 71-80 age group was the highest (20.0%). The difference was significant. The incidence rate of women aged from 0.70 to 80 years old was higher than that of men, and the incidence rate was 0.70-80 years old in the age group of 50-60 years and 60-70 years old, the incidence of which was 0.70-80 years old. There was no significant difference between serum PTH and age. 4. There was no significant correlation between serum PTH and age in Naxi nationality in Lijiang, Yunnan Province. It may be suggested that the age of Naxi population in Lijiang City of Yunnan Province increased with age, and there was no significant correlation between serum PTH and age, which suggested that the age of Naxi nationality in Lijiang City of Yunnan Province was higher than that of Naxi ethnic group in Lijiang City, Yunnan Province. The risk of osteoporosis is increased. Conclusion 1. The incidence of osteoporosis in Naxi nationality in Lijiang City, Yunnan Province, is lower than that in other regions of the country, and the peak bone mass may be higher than that in other regions of the country. 2. Population height, weight, age, waist circumference, Hip circumference and OSTA were correlated with calcaneal quantitative ultrasound T value and OSTA, the BMD of smoking drinkers was significantly lower than that of non-smokers, osteoporosis was positively correlated with alcohol consumption, environmental factors were important factors. Sunshine time, labor, dietary life and bone mineral density were closely related. 3. The incidence of osteoporosis increased year by year with the increase of age in the investigated population of Naxi nationality in Lijiang City, Yunnan Province. Both sexes had the highest incidence in the 70-80 age group. This was associated with the increase of age, the decline of body function, and the decrease of estrogen levels in postmenopausal women. It may indicate that the risk of osteoporosis increases with the increase of age in the Naxi ethnic group in Lijiang, Yunnan Province.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R580

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