中国骨质疏松杂志

早期类风湿关节炎骨质疏松发生情况研究

Study of osteoporosis related factors in the early rheumatoid arthritis

DOI：10.3969/j.issn.1006.7108.2016.03.021

英文关键词:Arthritis Rheumatoid Osteoporosis Early

基金项目:

作者	单位
胡晶1 高克明1 周琼竦1 陆忠民2 胡宏1 王美美3*	1.东南大学附属江阴市人民医院肾脏风湿科，江阴214400 2.东南大学附属江阴市人民医院检验科，江阴214400 3.东南大学附属中大医院风湿免疫科,南京210009

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中文摘要:

目的探讨早期类风湿关节炎（RA )患者骨质疏松（OP )发生情况及相关临床危险因素。方法收集94例住院早期RA患者（男29例，女65例）和81例正常对照组（男28例，女53例），采用DEXA法测定股骨颈、Ward区、大转子、总股骨区和腰椎2 ~4部位骨密度（BMD ),采用酶联免疫吸附法检测骨代谢指标（CTX、PINP )和炎症因子（IL-17、IL-6、TNF-α)。采用Logistic回归分析研究相关的风险因素。结果早期RA患者的股骨颈、GT区、L2、L4部位BMD明显低于正常对照组，早期RA的骨质疏松发生率为14.89% ( 14/94 ),明显高于对照组6. 17% ( 5/81 )。早期RA患者的CTX、TNF-α、IL-6、 IL-17水平较正常对照组高。Logistic回归分析显示早期RA患者年龄（OR = 1.08, P <0.001, 95% CI：1.04~1.12 )、DAS28 评分（OR = 1.56, P =0.0102，95% CI：1. 11 ~2. 19 )是发生骨质疏松的危险因素。结论早期RA患者骨质疏松发生率高，临床应重视。年龄、DAS28评分是早期RA患者发生骨质疏松的危险因素，改善RA病情有助于骨质疏松的预防及治疗。

英文摘要:

Objective To determine the relationship between osteoporosis and earlyrheumatoid arthritis and the risk factors for osteoporosis. Methods A total of 94 early rheumatoid arthritis patients were randomly selected in the department of kidney and rheumatology in the hospital, including 29 males and 65 females. A total of 81 health cases were randomly selected in our hospital, including 28 males and 53 females as control. BMD were determined using dual energy X-ray absorptiometry. Bone metabolism and inflammatory cytokines were examined with quantitative enzyme-linkedimmune-sorbent assay. Logistic regression was used for investigate the risk factors. Results Compared with control group, BMD in early rheumatoid arthritis group was significantly decreased. The prevalence of osteoporosis in early rheumatoid arthritis group was 14. 89% ( 14/94 ). According to values of Bone metabolism and inflammatory cytokines, CTX, TNF-α, L-6 and IL-17 were markedly increased in early rheumatoid arthritis group. Logistic regression showed that age and DAS 28 score were significantly positively correlated with osteoporosis. Conclusion The incidence of osteoporosis are higher in early rheumatoid arthritis patients than health cases. Age and DAS 28 score are the important risk factors for early rheumatoid arthritis patients with osteoporosis. Measures relieve symptoms of RA can help prevention and treatment of osteoporosis.

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