Hung Tsung-Hsing, Hsieh Yu-Hsi, Tsai Chih-Chun, Tseng Chih-Wei, Tseng Kuo-Chih, Tsai Chen-Chi
Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Taiwan.
Intern Med. 2011;50(21):2563-8. doi: 10.2169/internalmedicine.50.5952. Epub 2011 Nov 1.
The relationship between osteonecrosis of the femoral head (OFH) and liver cirrhosis is controversial. The aim of this study was to determine whether liver cirrhosis is associated with the occurrence of OFH.
We used the National Health Insurance Database, derived from the Taiwan National Health Insurance program. The study cohort comprised 40,769 adult patients with liver cirrhosis. The comparison cohort consisted of 40,769 randomly selected age- and sex-matched subjects.
During the 3-year follow-up period, there were 321 (0.8%) cirrhotic patients with OFH, and 126 (0.3%) non-cirrhotic patients with OFH (p<0.001). Cox's regression analysis, adjusted by the patients' age, sex, and other confounding factors, showed that the cirrhotic patients had a higher risk for occurrence of OFH than non-cirrhotic patients during the 3-year period (hazard ratio=2.38, p<0.001). In this 3-year study, the incidence density of cirrhotic patients hospitalized for OFH was 3 episodes/1,000 person-year.
We conclude that cirrhotic patients have a higher risk for occurrence of OFH than non-cirrhotic patients.
股骨头坏死（OFH）与肝硬化之间的关系存在争议。本研究的目的是确定肝硬化是否与OFH的发生有关。
我们使用了来自台湾国民健康保险计划的国民健康保险数据库。研究队列包括40769名成年肝硬化患者。比较队列由40769名随机选择的年龄和性别匹配的受试者组成。
在3年的随访期内，有321名（0.8%）肝硬化患者发生OFH，126名（0.3%）非肝硬化患者发生OFH（p<0.001）。经患者年龄、性别和其他混杂因素调整后的Cox回归分析显示，在3年期间，肝硬化患者发生OFH的风险高于非肝硬化患者（风险比=2.38，p<0.001）。在这项为期3年的研究中，因OFH住院的肝硬化患者的发病密度为每1000人年3例。
我们得出结论，肝硬化患者发生OFH的风险高于非肝硬化患者。
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