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| RA患者骨密度的特点及影响骨折风险的因素 |
| The characteristics of bone mineral density and risk factors of fracture in patients with rheumatoid arthritis |
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| DOI：10.3969/j.issn.1006.7108.2018.11.014 |
| 中文关键词: 类风湿关节炎 骨质疏松 骨密度 骨折风险 |
| 英文关键词:rheumatoid arthritis osteoporosis bone mineral density fracture risk |
| 基金项目:内蒙古自治区自然科学基金项目（2012MS1106） |
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| 中文摘要: |
| 目的 探讨类风湿关节炎(rheumatoid arthritis，RA)患者骨密度的特点及其骨折的风险度，并分析其影响因素。方法 选取2016年1月至2017年12月于我院已确诊的RA患者共70例(RA组)，体检的正常健康人群共79例（对照组），收集两组人群的病史及骨折风险相关的基本临床资料，且采用双能X线骨密度仪测定两组人群股骨的3D骨密度、二维骨密度，并进行骨折跌倒评分及FRAX评分，分析RA患者的骨密度变化情况、骨折风险性和疾病的活动度，探讨影响RA骨密度减低的因素。结果 与正常对照组相比，RA组患者无论是体积骨密度还是皮质厚度都明显降低（t=6.135，P<0.01）,且均与二维BMD的变化趋势相一致；RA患者骨折风险度明显高于正常对照组人群(t=6.663，P<0.01），RA患者疾病的活动度与骨密度的改变之间无明显相关性（r=–0.085, P>0.05），但激素的使用是其骨量流失的影响因素（χ2=12.366，P<0.05）。结论 RA患者存在明显的骨量流失和骨折风险性增加，骨密度的改变主要表现为骨小梁和骨皮质密度均减低，因此，积极控制原发病并预防糖皮质激素性骨质疏松有重要的临床意义。 |
| 英文摘要: |
| Objective To investigate the characteristics and fracture risk of patients with rheumatoid arthritis (RA) and to analyze its influencing factors. Methods Seventy cases of patients with RA (RA group) and 79 cases of healthy controls (Control group) were selected in our hospital between January 2016 and December 2016. Their history and fracture-related basic clinical information were collected. 3D and 2D of bone mineral density (BMD) at the femurs were determined using dual energy X-ray absorptiometry in the two groups. The fall and FRAX score were also determined. RA patients with changes in bone mineral density, fracture risk analysis, and disease activity were accessed. The influential factors of BMD decrease in RA patients were explored. Results The volume bone density and cortical thickness were significantly reduced in RA group compared with those in control group (t=6.135, P< 0.01), which was consistent with the change trend of two-dimensional BMD. The fracture risk of RA patients was significantly higher than that of the normal controls (t=6.663, P< 0.01). There was no significant correlation between disease activity and BMD in patients with RA (r=-0.085, P>0.05). However, the use of glucocorticoids may be the influential factor of the bone loss (χ2=12.366, P<0.05). Conclusion Obvious decrease of bone mass and increase in fracture risk exist in RA patients. The change of BMD appears in the reduction of the trabecular bone and cortical bone. Therefore, active control of the original diseases and prevention of glucocorticoid-induced osteoporosis play an important role in the clinical practice. |
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