中国骨质疏松杂志

427例类风湿关节炎患者骨质疏松阳性率分析

Analysis of the positive rate of osteoporosis in 427 rheumatoid arthritis patients

DOI：10.3969/j.issn.1006-7108.2018.12.003

英文关键词:rheumatoid arthritis osteoporosis bone mineral density dual energy X-ray absorptiometry

基金项目:2007年军队系统国家中医药管理局重点专科（专病）建设项目（2007ZDZB001）

作者	单位
徐子涵郭郡浩* 杨路昕林彤彤赵智明蔡辉	解放军南京总医院中西医结合科，江苏南京 210002

摘要点击次数: 1200

全文下载次数: 500

中文摘要:

目的分析类风湿关节炎（rhuematoid arthritis，RA）患者骨质疏松症（osteoporosis，OP）的阳性率。方法回顾性分析近3年在解放军南京总医院接受双能X线吸收法（dual energy X-ray absorptiometry，DXA）检查的RA患者骨密度（bone mineral density，BMD）资料，DXA检测的部位包括腰椎L1~4、左股骨颈和左全髋，以T值、Z值最低处作为诊断，并与同期体检人群进行对照。分别统计两组中骨量正常、低骨量、骨质疏松及严重骨质疏松的检出率，以及各检测部位BMD值，分析两组各部位BMD随年龄变化特点。结果 RA患者427例，骨量正常者占40.7%（174/427），低骨量者占34.0%（145/427），骨质疏松者占19.7%（84/427），严重骨质疏松者占5.6%（24/427）；对照组人群1343例，骨量正常者占57.6%（773/1343），低骨量者占34.0%（456/1343），骨质疏松者占7.6%（102/1343），严重骨质疏松者占0.9%（12/1343）。经χ2检验，两组人群BMD检测结果分布不同，差异有统计学意义（χ2=97.673，P=4.918E-21），RA组BMD异常率明显高于对照组（χ2=36.794，P=1.313E-9）。RA组腰椎L1~4、左股骨颈、左全髋BMD较对照组均明显降低，差异有统计学意义。该现象在40～79岁年龄段的RA患者中尤为显著；随着年龄的增长，与对照组相比，40岁以上的RA患者左股骨颈、左全髋BMD的下降趋势尤为明显。结论 RA患者骨质疏松阳性率较高，40岁以上的RA患者随着年龄的增长BMD下降尤为明显，应尽早进行DXA检查并定期随访，积极防治OP及其并发症。

英文摘要:

Objective To analyze the positive rate of osteoporosis in patients with rheumatoid arthritis (RA). Methods Bone mineral density (BMD) data of RA patients examined by dual-energy X-ray absorptiometry (DXA) in Nanjing General Hospital in the past 3 years were retrospectively analyzed. The site measured using DXA included lumbar spine L1-4, left femoral neck and left hip. Osteoporosis was diagnosed using the lowest value of T and Z scores. The results were compared with the population attended physical examination during the same period. The detection rates of normal bone density, low bone mass, osteoporosis and severe osteoporosis in the two groups were counted, BMD data of each test site were compared between the two groups, and the characteristics of BMD with age were analyzed in the two groups. Results There were 427 RA patients, 40.7% (174/427) with normal bone density, 34.0% (145/427) with low bone mass, 19.7% (84/427) with osteoporosis, and 5.6% (24/427) with severe osteoporosis. There were 1343 people in the control group, 57.6% (773/1343) with normal bone density, 34.0% (456/1343) with low bone mass, 7.6% (102/1343) with osteoporosis, and 0.9% (12/1343) with severe osteoporosis. In the χ2 test, the distribution of BMD in the two groups was different, and the difference was statistically significant (χ2 = 97.673, P = 4.918E-21). The BMD abnormal rate in RA group was significantly higher than that in the control group (χ2 = 36.794, P = 1.313 E-9). BMD of lumbar spine L1-4, left femoral neck and left hip in RA group was significantly lower than that in the control group, and the differences were statistically significant. This phenomenon was especially significant among RA patients aged between 40 and 79 years. With the increase of age, compared with the control group, the decline in BMD of left femoral neck and left hip in RA patients aged over 40 years was particularly significant. Conclusion The positive rate of osteoporosis in RA patients is very high, and the decrease of BMD in RA patients aged over 40 years is particularly evident with increase in age. DXA examination should be performed as early as possible, and regular follow-up should be performed to prevent and control OP and its complications.

查看全文查看/发表评论下载PDF阅读器

关闭