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| 绝经后女性类风湿关节炎患者骨质疏松影响因素的回顾性研究 |
| Factors associated with osteoporosis in postmenopausal women with rheumatoid arthritis:A retrospective study |
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| DOI：10.3969/j.issn.1006.7108.2015.07.008 |
| 中文关键词: 类风湿关节炎 绝经后 骨质疏松 骨密度 |
| 英文关键词:Rheumatoid arthritis Postmenopausal Osteoporosis Bone mineral density |
| 基金项目:2012年广东省科技计划项目：树突细胞诱导扩增FOXP3 +调节性T细胞治疗系统性红斑狼疮的实验研究（2012B061700006) |
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| 中文摘要: |
| 目的 通过分析绝经后女性类风湿性关节炎(RA)患者骨密度与临床资料的相关性，探讨影响骨密度的相关因素。方法 收集64例绝经后女性RA患者一般临床资料、腰椎及股骨的平均骨密度（BMD)、骨代谢指标、实验室检查指标，根据骨密度分为骨质疏松组和非骨质疏松组，比较临床资料并分析可能影响骨密度的因素。结果 64例患者平均年龄(58. 47 ±5.81) 岁，平均病程5.5(2.0,12.0)年。骨质疏松比例为62.5% (40/64)。骨质疏松组的绝经时间、ESR、纤维蛋白原、DAS28高于非骨质疏松组，绝经年龄、体重、BMI、ALB、DMARDs及抗骨吸收药物使用率低于非骨质疏松组，病程2年以上的患者骨质疏松发病率较高，其炎症指标亦高于同病程非骨质疏松组。简单相关分析提示BMD与绝经年龄、体重、BMI、ALB正相关，与 DAS28负相关。Logistic回归分析提示绝经年龄（OR = 4. 750，95%CI：1. 30247. 327，P = 0. 018)是影响绝经后女性RA患者 BMD的独立因素。多重线性回归方程提示BMD与BMI正相关，与DAS28负相关。结论 绝经后RA患者BMD受绝经年龄、BMI、DAS28的影响。绝经年龄是影响绝经后女性RA患者BMD的独立因素。 |
| 英文摘要: |
| Objective The present study is to explore the factors associated with bone mineral density (BMD) by analyzing the correlation between BMD and clinical data in postmenopausal women with rheumatoid arthritis (RA). Methods The participants were 64 postmenopausal women with RA. General clinical data，serum levels of bone metabolism index，and clinical manifestations were collected. BMD of the lumbar vertebrae and femur were measured using dual energy X-ray absorptiometry. The patients were divided to osteoporotic group and non osteoporotic group according to their BMD. The data were compared and potential related factors were analyzed. Results The mean age of the patients was 58. 47 ±5. 81 years and the duration of the disease was 5. 5 (2.0,12.0) years. 62. 5% (40/64) of patients had osteoporosis. Patients in osteoporotic group had higher ESR，fibrinogen，and DAS28，and longer menopausal years than those in non-osteoporotic group. They also had younger menopause age，lower body mass index (BMI)，weight，albumin，utilization ratio of DMARDs and anti-resorptive medication. Patients with more than two years RA duration had a higher incidence of osteoporosis，and their inflammation indexes were higher than those in non-osteoporotic patients. Simple correlation analysis showed that BMD was positively correlated with menopause age，weight，BMI，and albumin， but negatively correlated with DAS28. Logistic regression showed that menopause age (OR =4. 750，95% CI：1. 302 - 17. 327，P =0. 018) was an independent factor to BMD in postmenopausal women with RA. The linear regression model showed that BMD was positively correlated with BMI but negatively correlated with DAS28. Conclusion BMD is associated with menopause age， BMI，and DAS28 in postmenopausal women with RA. Menopause age is an independent factor to BMD in postmenopausal women with RA. |
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