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亚临床炎症是否会导致老年人膝关节功能障碍?超声炎症发现的高患病率。

Does subclinical inflammation contribute to impairment of function of knee joints in aged individuals? High prevalence of ultrasound inflammatory findings.

机构信息

Department of Rheumatology, Hôpital Ambroise Paré, APHP, UPRES EA 2506, Université Versailles St-Quentin, Boulogne-Billancourt, France.

Department of Rheumatology, Sapienza University of Rome, Rome, Italy,

出版信息

Rheumatology (Oxford). 2015 Sep;54(9):1622-9. doi: 10.1093/rheumatology/kev032. Epub 2015 Apr 13.

Abstract

OBJECTIVES

To investigate the prevalence of knee US findings of inflammation and structural damage in aged individuals (≥60 years) of a long-term population-based cohort and to correlate these findings with demographic, clinical and laboratory parameters.

METHODS

Cross-sectional clinical and US investigation of both knee joints during the 2010 follow-up of the prospective population-based Bruneck Study. Demographic variables, physical activity, comorbidities, medications, pain, and functional scales related to the knee joints were recorded. US-assessed parameters were synovial hypertrophy, power Doppler signal, joint effusion, cartilage abnormalities, osteophytes, enthesopathy and bursitis. Statistics included univariate and multivariate regression analysis.

RESULTS

A total of 488 subjects (mean age 72.5 years; 53.5% females, 46.5% males) were examined by clinical assessment, and 433 of these underwent US examination of both knees. Both inflammatory and structural abnormalities were found in 296 (68.8%) subjects. Inflammatory abnormalities were significantly associated with age in years, male gender, diabetes and the presence of knee joint symptoms. In the multivariate analysis, age, male gender and knee swelling emerged as independent predictors of inflammation [odds ratio (OR) (95% CI) = 1.06 (1.03, 1.09), 2.55 (1.55, 4.21) and 5.92 (1.99, 17.58), respectively].

CONCLUSION

The present study showed a high prevalence of US inflammatory abnormalities in the knee joints of a normal aged population. These data suggest a substantial contribution of inflammation in progressive impairment of joint function with age.

摘要

目的

调查长期人群基础队列中≥60 岁老年人膝关节超声炎症和结构损伤的发生率,并将这些发现与人口统计学、临床和实验室参数相关联。

方法

对前瞻性人群基础 Bruneck 研究 2010 年随访中双侧膝关节进行横断面临床和超声检查。记录人口统计学变量、身体活动、合并症、药物、膝关节相关疼痛和功能评分。超声评估的参数包括滑膜肥厚、能量多普勒信号、关节积液、软骨异常、骨赘、肌腱病和滑囊炎。统计学分析包括单变量和多变量回归分析。

结果

共有 488 名受试者(平均年龄 72.5 岁;53.5%女性,46.5%男性)接受了临床评估,其中 433 名受试者接受了双侧膝关节超声检查。296 名(68.8%)受试者存在炎症和结构异常。炎症性异常与年龄、男性、糖尿病和膝关节症状显著相关。多变量分析显示,年龄、男性和膝关节肿胀是炎症的独立预测因素[比值比(OR)(95%置信区间)=1.06(1.03,1.09)、2.55(1.55,4.21)和 5.92(1.99,17.58)]。

结论

本研究显示正常老年人群膝关节超声炎症异常的发生率较高。这些数据表明炎症在关节功能随年龄逐渐受损中起着重要作用。

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