慈溪市骨质疏松症社区干预初步结果△

Preliminary outcomes of community intervention for osteoporosis in Cixi city

摘要:

[目的]探讨在社区骨质疏松症教育与干预的初步结果。[方法]2019 年 7 月—2020 年 6 月，在慈溪市 16 家卫生机构设立骨质疏松症干预点，共纳入 854 例研究对象，随机分为两组，459 例列入干预组，给予骨质疏松教育与相应干预；395 例为对照组，常规社区管理，未给予相关教育和干预。干预期为 1 年，与对照组比较，并比较干预前后研究对象对骨质疏松症危险因素认知的变化，以及骨密度（bone mineral density, BMD）的变化和相关不良事件发生情况。[结果]干预前的干预组与对照组比较，对骨质疏松和跌倒危险因素认知率差异无统计学意义（P＞0.05）；干预后对各项危险因素的认知率均明显上升，显著高于对照组（P＜0.05）。与干预前相比，干预后干预组的腰椎 BMD 和股骨颈 BMD 均显著增加（P＜0.05），而对照组干预前后腰椎 BMD 和股骨颈 BMD 均无显著变化（P＞0.05）。干预后干预组的腰椎 BMD [(0.7±0.1)g/cm² vs (0.5±0.1)g/cm² , P＜0.05] 和股骨颈 BMD [(0.8±0.1)g/cm² vs (0.7±0.1)g/cm² , P＜0.05] 均显著高于对照组。为期 1 年的干预过程中，干预组骨折、残疾、死亡发生率为 122/459 （26.6%），低于对照组的 111/395（28.1%），但差异无统计学意义（P＞0.05）。[结论] 骨质疏松症社区教育与干预可显著提升研究对象对相关危险因素的认知率，增加骨密度，对于骨质疏松骨折的预防有积极意义。

Abstract:

[Objective] To explore the preliminary results of community education and intervention for osteoporosis (OP). [Methods] From July 2019 to June 2020, the intervention station for OP were set up in 16 primary healthcare unites in Cixi city, a total of 854 subjects were included and randomly divided into two groups. Of them, 459 cases in the intervention group (IG) were given education and correspond- ing intervention for OP, while 395 cases in the control group (CG) received routine community management without relevant education and intervention for OP with the 1-year intervention period. Compared with the control group, and before and after the intervention, the under- standing to OP risk factors, bone mineral density (BMD) and occurrence of related adverse events were evaluated. [Results] Although there was no significant difference in the recognition rate of OP and fall risk factors between the IG and the CG before intervention (P＜0.05), the average cognition rate to all risk factors increased significantly in the IG after the intervention, which was significantly higher than the CG (P＜0.05). Both the lumbar bone mineral density(BMD) and femoral neck BMD significantly increased in the IG after intervention compared with those before intervention (P＜0.05), whereas which remained unchanged in the CG (P＞0.05). The IG proved significantly superior to the CG in terms of lumbar BMD [(0.7±0.1)g/cm² vs (0.5±0.1)g/cm² , P＜0.05] and femoral neck BMD [(0.8±0.1)g/cm² vs (0.7±0.1)g/cm² , P＜0.05] af- ter intervention. During the 1-year intervention, the incidence of adverse events, including fracture, disability and death, was 122(26.6%) in the IG and 111 (28.1%) in the CG, which in the former were lower than the latter despite of that the difference was not statistically significant (P＞0.05). [Conclusion] This community education and intervention for OP does significantly improve the awareness rate of related risk fac- tors and increase bone density, which has positive significance for the prevention of osteoporotic fracture.