酒精性股骨头坏死

酒精类饮料的消费量日趋增加，股骨头坏死(英文缩写ANFH)的发病率也日渐增加，各国不同学者报道情况不一。在美国酒精致骨坏死的发病率为0.3%、日本为2%、南斯拉夫为5%[1]二。日本的第一次描述性流行病学全国调查，危险因素:酒精31%，与激素致骨坏死发病率持平[2]；第二次调查酒精性骨坏死发病率为23%；第三次调查发率为23%[3]，仅次于激素性骨坏死[4]。第四次调查酒精为27%。过量饮酒和特发性股骨头缺血坏死之间的联系已受到骨科医师的广泛重视。MatSuo K和Hirota Y的研究显示：特发性骨坏死发病危险性增高对偶然饮酒者0R(比数比)为3.2，规律性饮酒者0R为13.1。每周饮酒量少于40Oml者OR为2.8;400一999ml者OR为9.4;等于和多于1000ml者OR为14.8，有明显的剂量应答关系。该研究还显示发病危险性的提高随着每周酒精摄入量的增加及酒年数增加而增高[5-6]，显示出酒精在特发性骨坏死发病上的立即作用和累积作用。

参考文献

1.董天华，郑召民。译，骨坏死病因、诊断与治疗。P，35.

2.Ninomiya S，Tagawa H，Miyanaga Y，et al:Nationwide epidemiologie survey

On idiopathic avascular necrosis of the femoral head. Annual Report of Researeh Committee on idiopathic Avaseular Neerosis of the Femoral Head in 1977.Toko，JaPan，Ministry of Health and Welfare of Japan，1978，PP19一25.

3.MasudaT: Epidemiologic survey on idiopathic avaseular necrosis of the femoralhead，in Annual Report of Researeh Conunittee on IdioPathie

Avaseular Necrosis the Femoral Head in1983.Tokyo.Japan，Ministry of Health and Welfare of Japan，1988，pp63一65.

4.Ninomiya:The state of idiopathic avaseular necrosis of the femoral head in JaPan，in Annual reportof Researeh Committeeon IdioPathic Avaseular necrosis of the Femoral Head in1987.Tyko Japan，Ministry ofHealth and Welfare of JaPan，1988，PP107一109.

5.MatsuoK，HirohataT，SugiokaY，etal:Influence of aleoholintake，cigarette smoking and occupational status on idiopathic osteoneerosis of the femoral head.Clin Orthop1998:234:115一123.

6.HirotaY，HirohataT，Fukudak，etal:Assoeiation of aleohol intake，cigarettesmoking，and occupational status with the risk of idiopathic osteoneerosis of the femoral head.Am J Epidemiol 1993;137:530一538.