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| 系统性红斑狼疮患者髋部骨密度特点分析及与疾病活动度的关系 |
| The relationship between bone density and disease activity in patients with systemic lupus erythematosus |
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| DOI：10.3969/j.issn.1006-7108.2019.12.012 |
| 中文关键词: 系统性红斑狼疮 骨质疏松 骨密度 骨折风险 |
| 英文关键词:systemic lupus erythematosus osteoporosis bone mineral density fracture risk |
| 基金项目:内蒙古自治区自然科学基金项目（2017MS0809） |
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| 中文摘要: |
| 目的 探讨系统性红斑狼疮（systemic lupussw erythematosus, SLE）患者骨密度的特点和骨折风险性，并分析其骨量变化与疾病活动度的关系。方法 选取2016年8月至2017年9月于我院确诊的SLE患者49例，体检的健康对照人群52名，收集受试者病史及与骨折风险相关的临床资料，采用双能X线骨密度仪测定两组人群股骨的3D骨密度（bone mineral density, BMD）、二维骨密度，探讨SLE骨量降低与疾病活动度的关系。结果 ①与对照组相比，SLE患者髋部骨小梁的体积骨密度明显降低（t= -0.47, P<0.05），股骨颈前节段、股骨转子侧面、股骨干前节段的皮质厚度均明显降低（t分别为-2.34、-2.10、-2.36, P均<0.05）；②与对照组相比，SLE组患者髋部二维骨密度明显降低（t= -2.64, P<0.05），且SLE患者骨折风险度明显高于对照组(t=-3.54, P<0.01）；③SLE组患者疾病活动相关的SLE-DAI积分与髋部骨小梁体积骨密度及股骨颈皮质厚度的减低呈正相关（B分别为1 203.32、1.94, P均<0.05），而与BMD的改变无明显相关性。结论 SLE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体积骨密度和二维骨密度的减低，且SLE病情活动度越高，骨小梁体积骨密度越低。积极控制原发病对预防骨质疏松有重要的临床意义。 |
| 英文摘要: |
| Objective To investigate bone density and the risk of fracture, and the relationship between changes in bone density and disease activity in patients with systemic lupus erythematosus (SLE). Methods 49 cases of SLE diagnosed in our hospital between August 2016 and September 2017 and 52 healthy individuals were included in this study. 3D bone mineral density (BMD) and two-dimensional BMD of femur in the two groups were measured by dual energy X-ray absorptiometry. The relationship between bone density, risk of fracture and disease activity were analyzed. Results (1) Compared with the control group, the hip trabecular volumetric bone density was significantly lower (t= -0.47, P<0.05), and the cortical thickness of the anterior femoral neck, the lateral aspect of the femoral trochanter and the anterior segment of the femoral shaft were significantly decreased in patients with SLE (t= -2.34, -2.10 and -2.36, respectively, all P<0.05); (2) Compared with the control group, the two-dimensional bone mineral density of hip in SLE group was significantly decreased (t= -2.64, P<0.05). The risk of fracture was significantly higher in SLE group than that of the control group (t= -3.54, P<0.01); (3) Positive correlation was observed between SLEDAI scores and reduction in hip trabecular volumetric bone density and cortical thickness of femoral neck (B=1203.32 and 1.94, both P<0.05). However, there was no obviously correlation between SLEDAI scores and two-dimensional BMD. Conclusion There was high risk of fracture and lower bone density in patients with SLE. The changes in bone mineral density were mainly manifested as trabecular volumetric bone mineral density and 2D bone density. And the change in trabecular volumetric bone mineral density was positively correlated with SLE disease activity. Thus, disease control of primary diseases has important clinical significance in preventing osteoporosis in SLE patients. |
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