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| 早期强直性脊柱炎骨密度分析 |
| Bone mineral density in early ankylosing spondylitis patients |
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| DOI：10.3969/j.issn.1006.7108.2016.08.005 |
| 中文关键词: 强直性脊柱炎 骨密度 骨质疏松 |
| 英文关键词:Ankylosing spondylitis Bone mineral density Osteoporosis |
| 基金项目:北京市科技计划课题（Z131107002213091);中日友好医院青年科技英才课题（2014-QNYC-B-02) |
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| 中文摘要: |
| 目的 探讨早期强直性脊柱炎（ankylosing spondylitis，AS)患者骨密度（bone mineral density，BMD)及BMD与其他临床指标的相关性。方法 回顾性研究调查2006年3月至2014年12月中日友好医院中医风湿病科确诊为早期AS患者120例，其中女性57例，平均年龄（31. 02 ±5. 94)岁；男性63岁，平均年龄（29. 79 ±6.87)岁。健康人107例，其中女性48例，平均年龄（32. 97±6. 47)岁；男性59例，平均年龄（29. 58 ±6. 65)岁。双光能X线法检测腰椎、股骨颈、股骨粗隆的BMD与年龄、病程、疾病活动性指标、影像学指标进行相关分析。结果（1)早期AS男性患者各部位的BMD均较健康人减低（P<0. 01),而女性患者则和健康人无统计学差异。（2)早期AS患者骨质疏松（osteoporosis,OP)6例（5% )，骨量减少（osteopenia,OT)36例 (21. 67% )。其中男性早期AS患者腰椎OP者5例（7. 93% ) ,OT者29例（46. 03% )。早期AS患者中，男性腰椎部位OP、OT 发生率较女性高（P <0.05),股骨颈及股骨粗隆部位OP/OT发生率无差异。（3)中、低年龄组中，早期AS患者的腰椎和股骨颈BMD较健康人显著减低，差异有统计学差异（P< 0.01)。（4)男性早期AS患者腰椎BMD与年龄呈显著负相关（P <0.01）。结论 早期AS男性患者即可出现显著BMD下降，OP发生率为7.93%,OT发生率为46.03%。其中腰椎部位BMD 减低及OT发生率更为突出。早期AS患者BMD的下降与疾病活动指标无关联。对于男性AS患者，在疾病早期即需要重视 OT及OP的诊断与防治。 |
| 英文摘要: |
| Objective To study bone mineral density (BMD) and its association with relevant clinical factors in patients with early Ankylosing Spondylitis ( AS ). Methods Patients diagnosed with AS in the China-Japan Friendship Hospital from March 2006 to December 2014 were retrospectively surveyed, and 120 early AS patients and 107 healthy controls were included in this analysis. BMD of lumbar spine, femoral neck, and trochanter were measured using dual energy X-ray absorptiometry. Correlation analyses with age, disease duration, disease activity index and radiological indicators were performed. Results (1) Male early AS patients had significant lower BMD at the lumbar spine, femoral neck, and trochanter than healthy controls (P <0.01), whereas in females there were no signiticance differences. (2) Among the 120 early AS patients, 6 had osteoporosis (OP) and 36 osteopenia (OT). The prevalence of OP and OT defined using lumbar spine BMD was significant higher in males than in females, whereas there were no gender differences if using femoral neck or trochanter BMD to define OP and OT. (3) In middle and younger age groups, BMD of the lumbar spine and femoral neck in early AS patients was significant lower than that of healthy controls (P < 0.01). (4) Correlation analyses showed that in patients with AS, there were no significant correlations between BMD and ESR, CRP and disease duration. BMD at lumbar spine in male patients was negatively correlated with age. Conclusion Early AS male patients had signiftcant BMD reduction, especially at lumbar spine. The prevalence of OP and OT in male patients was 7. 93% and 46.03%，respectively. There were not significant correlations between BMD and ESR, CRP and disease duration. Our findings suggest that male AS patients should receive more attention in the diagnosis and treatment of OP and OT. |
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