Department of Rheumatology, Beaumont Hospital, Dublin, Ireland.
Eur Neurol. 2009;62(6):369-74. doi: 10.1159/000242444. Epub 2009 Oct 1.
BACKGROUND/AIMS: Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.
Over a 6-month period, 50 post-polio patients attending outpatient clinics completed a questionnaire, and subsequently their medical records were reviewed. Demographic data and details of treatment were extracted. The patients underwent a dual-energy X-ray absorptiometry scanning to quantify bone mineral density.
Thirty subjects (60%) were females (26 were postmenopausal). The average age of females was 60 +/- 13.4 years and of men 59 +/- 16.8 years. Overall, 41 (82%) of the patients had experienced falls in the last 5 years and 32 (64%) in the last 6 months. Nineteen (38%) of the patients had experienced a bone fracture in the last 5 years. Based on the bone mineral density data, 28 (56%) of the patients were diagnosed with OP and 20 (40%) had osteopenia, but only 8 (16%) received anti-resorptive therapy. Of the 19 patients who had a fracture, 14 (74%) had OP and 5 (26%) had osteopenia, of whom only 6 (32%) received anti-resorptive therapy. Eight out of 9 fractures of the neck of femur occurred in the weaker leg.
Post-polio patients are a high-risk group for fracture, and thus bone density assessment, review of falls risk and therapeutic intervention should be considered for all patients. Both osteopenia and OP are associated with increased fracture risk.
背景/目的：自 20 世纪 50 年代爱尔兰的脊髓灰质炎疫情以来，大多数脊髓灰质炎幸存者已进入其生命的第六和第七个十年。关于这些患者的骨密度和骨折风险的数据很少。2006 年，我们对在一所大学教学医院的风湿病和神经科门诊就诊的脊髓灰质炎后患者进行了审核。我们的目的是确定骨质疏松症（OP）的患病率，跌倒和骨折，并评估骨密度与其他可能导致 OP 的潜在因素之间的关联。
在六个月的时间里，50 名在门诊就诊的脊髓灰质炎后患者完成了问卷调查，随后对他们的病历进行了审查。提取了人口统计学数据和治疗细节。患者接受了双能 X 射线吸收法扫描以定量骨矿物质密度。
30 名受试者（60％）为女性（26 名绝经后）。女性的平均年龄为 60 +/- 13.4 岁，男性为 59 +/- 16.8 岁。总体而言，41 名（82％）患者在过去 5 年内发生过跌倒，32 名（64％）在过去 6 个月内发生过跌倒。19 名（38％）患者在过去 5 年内发生过骨折。根据骨矿物质密度数据，28 名（56％）患者被诊断为 OP，20 名（40％）患者患有骨质疏松症，但只有 8 名（16％）接受了抗吸收治疗。在 19 名骨折患者中，14 名（74％）患有 OP，5 名（26％）患有骨质疏松症，其中只有 6 名（32％）接受了抗吸收治疗。9 例股骨颈骨折中有 8 例发生在较弱的腿上。
脊髓灰质炎后患者是骨折的高危人群，因此应考虑对所有患者进行骨密度评估，跌倒风险评估和治疗干预。骨质疏松症和 OP 均与骨折风险增加相关。
