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| 绝经后类风湿关节炎女性骨吸收与放射学进展相关 |
| Bone resorption was correlated with radiologic progression in postmenopausal women withrheumatoid arthritis |
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| DOI： |
| 中文关键词: 类风湿关节炎 骨形成 骨吸收 骨量减少 骨质疏松 绝经后 |
| 英文关键词:Ｒheumatoid arthritis Bone formation Bone resorption Osteopenia Osteoporosis Postmenopausal |
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| 中文摘要: |
| 目的 探讨绝经后类风湿关节炎(rheumatoid arthritis，ＲA)患者骨代谢指标与疾病活动指标、骨矿物质密度(bonemineral density，BMD)和放射学进展的相互关系。方法 本研究共募集了 68 例绝经后 ＲA 患者。血清检测指标包括红细胞沉降率(ESＲ)、C 反应蛋白(CＲP)、类风湿因子(ＲF)和抗环胍氨酸肽抗体(CCP)。同时检测了钙、维生素 D、骨碱性磷酸酶(BAP)和 β 胶原特殊序列(β-crosslaps) 的水平。采用双能 X 线骨吸收仪(DXA) 测量腰椎和左股骨颈的 BMD(g/cm 2 )。DAS28 和 Sharp 评分分别用于计算疾病活动度和放射学进展评估。运用 Spearman 相关分析对临床血清标记和疾病指标的相关性进行分析。结果 纳入患者的异常 BMD 比率为 94. 12%，其中 29. 41% (20/68)为骨量减少，而 64. 71% (44/68)为骨质疏松。ESＲ、CＲP 和 DAS28 之间显著相关(P ＜0. 05)，均提示疾病活动。血清 β-crosslaps 水平与任一疾病活动指标均无相关
(p 均 ＞0. 05)，但与 Sharp 评分呈正相关(r =0. 776，P =1 ×10－6 )。结论绝经后 ＲA 患者骨量减少及骨质疏松现象突出，可能与疾病活动和/或关节结构破坏有关。β-crosslaps 是与放射学进展相关而与疾病活动无关的有价值的血清标记。 |
| 英文摘要: |
| Objectives To determine the levels of bone turnover markers in patients with rheumatoid arthritis (ＲA) and the
correlation with disease activity index，bone mineral density ( BMD)，and radiographic progression． Methods Sixty-eight
postmenopausal women with ＲA were recruited in our study． Serologic measurement including erythrocyte sedimentation rate
(ESＲ)，C-reactive protein (CＲP)，rheumatoid factor (ＲF) and anti-cyclic citrullinated peptide (anti-CCP) were analyzed．
Calcium，vitamin D，bone alkaline phosphatase (BAP) β-crosslaps were also detected． Bone mineral density (BMD，g/cm 2 ) of
the lumbar spine and the left femoral neck was measured using dual-energy X-ray absorptiometry (DXA)． DAS28 and Sharp score
were separately calculated for disease activity and radiographic progression evaluation． Spearman correlation analysis was conducted
between clinical biomarkers and disease indexes． Ｒesults The overall rate of patient with abnormal BMD was 94. 12 %，with
29. 41% (20/68) of osteopenia and 64. 71% (44/68) of osteoporosis，respectively． ESＲ，CＲP，and DAS28 were significantly
correlated with each other showing consistent disease activity (P ＜0. 05)． Serum β-crosslaps level (452. 87 ±202. 40ug/l) was not
correlated with any of disease acidity markers (all P ＞0. 05) but was positively correlated with Sharp score (150. 76 ± 59. 71) in
postmenopausal women with ＲA (r = 0. 776，P = 1 × 10－6 )． Conclusion Osteopenia and osteoporosis are predominant in ＲA
which might be related to disease activity and/or structural damage． β-crosslaps implies radiographic progression instead of disease activity． |
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