Analysis of Risk Factors for Secondary Osteoporosis in Elderly Stroke Patients with Hemiplegia
WANG Li-xin, LI Qing-fen, GAO Jun, et al
Department of Geriatrics,Changzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Changzhou Jiangsu 213000
Abstract:【Objective】 To investigate the influencing factors of secondary osteoporosis in elderly stroke patients with hemiplegia. 【Methods】 The clinical data of 60 elderly stroke patients with hemiplegia who were admitted to our hospital from January 2018 to January 2021 were retrospectively analyzed. According to whether there was secondary osteoporosis, they were divided into the occurrence group and the non-occurrence group. The age, course of disease, gender, body mass index (BMI), co-morbidities, involved circulatory part, homocysteine (Hcy), blood pressure [Systolic blood pressure (SBP), diastolic blood pressure (DBP)], blood lipids [high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC)], coagulation indexes [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), D-dimer (DD)] and other clinical related data of the two groups of patients were compared. Multivariate logistic regression was used to analyze the risk factors for secondary osteoporosis in patients. 【Results】 Among the 60 elderly stroke patients with hemiplegia, 26 (43.34%) patients had secondary osteoporosis, and they were classified as the occurrence group; the remaining 34 cases (56.66%) did not occur, and they were classified as the non-occurrence group. There were no significant differences in age, course of disease, BMI, blood pressure, blood lipids, and coagulation indexes between the two groups (P>0.05). The proportion of women, hypertension, multiple infarctions of unilateral anterior circulation, LDL-C and Hcy levels in the occurrence group were higher than those in the non-occurrence group (P<0.05). Multivariate Logistic regression analysis showed that gender (OR=3.421, 95%CI=2.011~6.087), involved circulation (OR=3.809, 95%CI=1.792~7.326), hypertension (OR=2.187, 95%CI=1.126~1.987), LDL-C(OR=0.968, 95%CI=0.621~3.874), Hcy (OR=4.932, 95%CI=2.154~6.514) were independent risk factors for secondary osteoporosis in elderly stroke patients with hemiplegia (P<0.05). 【Conclusion】 Gender, hypertension, involved circulatory fraction, LDL-C and Hcy are risk factors for secondary osteoporosis in elderly stroke patients with hemiplegia.
王立新, 李庆芬, 高俊, 杨聪慧. 老年脑卒中偏瘫患者继发骨质疏松的危险因素分析[J]. 医学临床研究, 2022, 39(5): 660-663.
WANG Li-xin, LI Qing-fen, GAO Jun, et al. Analysis of Risk Factors for Secondary Osteoporosis in Elderly Stroke Patients with Hemiplegia. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 660-663.
[1] 林书旭,李平,陈小紫,等. 社区老年人群心血管病流行病学调查、危险因素分析及防控措施研究[J].解放军预防医学杂志,2019,37(7):51-52.
[2] RATANAPINUNCHAI J, MATHIYAKOM W, SUNGKARAT S. Scapular upward rotation during passive humeral abduction in individuals with hemiplegia post-stroke[J].Ann Rehabil Med,2019,43(2):178-186.
[3] CHEUNG A M, KAPRAL M K. Response by cheung and kapral to letter regarding article, "screening and treatment for osteoporosis after stroke: results from the ontario stroke registry"[J].Stroke,2019,50(10):308.
[4] LIN S M, WANG J H, LIANG C C,et al. Statin use is associated with decreased osteoporosis and fracture risks in stroke patients[J].J Clin Endocrinol Metab,2018, 103(9):3439-3448.
[5] 夏燕,李文,黄贝瑛,等. 心脑血管疾病及其危险因素对老年骨质疏松的影响及干预方案[J].中国老年学杂志,2021,41(1):12-15.
[6] 郑春妹,童玉梅,吴惠,等. 骨质疏松患者骨折术后再发骨折的危险因素分析[J].中国卫生统计,2021,38(5):773-774.
[7] 张薇,祝艳红. 超高龄患者骨质疏松症与心血管病危险因素的相关性分析[J].国际护理学杂志,2018,37(23):3187-3192.
[8] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[9] 杜桂迎,余卫,林强,等. WHO双能X线吸收仪骨质疏松症诊断标准及其相关问题[J].中华骨质疏松和骨矿盐疾病杂志,2016,9(3):330-338.
[10] STERNBERG Z. Cardiovascular autonomic dysfunction: link between multiple sclerosis osteoporosis and neurodegeneration[J].Neuromolecular Med,2018,20(1):37-53.
[11] 常四鹏,王炎强,耿德勤,等. 颅内动脉粥样硬化性狭窄致首发缺血性脑卒中老年患者并发骨质疏松的危险因素分析[J].实用医学杂志,2018,34(6):890-896.
[12] YAMADA S, INABA M. Osteoporosis as a risk factor for cardiovascular disease[J].Clin Calcium,2019,29(2):171-177.
[13] 郭凤艳,王晓薇,蒋世峰,等. 老年男性骨质疏松病人骨代谢标志物与心脑血管疾病相关性的研究[J].实用老年医学,2020,34(6):601-604.
[14] ZHANG J,LAI Z H,SHI L,et al. Correction: Repeated superovulation increases the risk of osteoporosis and cardiovascular diseases by accelerating ovarian aging in mice[J].Aging (Albany NY),2018,10(9):2535.
[15] BARZILAY J I,BUZKOVA P,CAULEY J A,et al. The associations of subclinical atherosclerotic cardiovascular disease with hip fracture risk and bone mineral density in elderly adults[J].Osteoporos Int,2018,29(10):2219-2230.
[16] YILMAZ V,UMAY E,GUNDOGDU I,et al. Effect of primary hypertension on treatment outcomes of patients with postmenopausal osteoporosis: A 5 year follow up retrospective study[J].High Blood Press Cardiovasc Prev,2019,26(1):61-67.
[17] 姚斌,陆国强,李海东. 老年人群高血压与骨质疏松关系的临床研究[J].中国药物与临床,2019,19(4):616-618.
[18] 董丽娟,高飞. 骨密度及骨代谢指标与同型半胱氨酸关系的研究进展[J].中国骨质疏松杂志,2020,26(8):1241-1244.
[19] 陈乐,周华东. 骨保护素与骨质疏松和动脉钙化[J].中华老年心脑血管病杂志,2019,21(4):437-439.