脊柱关节炎患者骨质疏松的诊断现状

发布时间：2018-02-10 06:04

本文关键词： 脊柱关节炎骨质疏松诊断强直性脊柱炎银屑病关节炎　出处：《中国骨质疏松杂志》2017年02期 　论文类型：期刊论文

【摘要】：脊柱关节炎是一类以累及脊柱和外周关节,或者关节、韧带和肌腱为主要表现的慢性炎症性风湿病的总称,主要临床症状为炎性背痛、不对称的周围性寡关节炎、起止点炎,以及某些器官损害如前葡萄膜炎、银屑病和慢性炎症性肠病。骨质疏松及低骨量在脊柱关节炎患者中普遍存在,是脊柱关节炎最常见的并发症。目前骨密度的主要检测方法包括双能X线吸收法(DXA)、跟骨超声、定量计算机断层扫描(QCT)等,常见的检测部位有腰椎前后位、腰椎侧位、股骨颈、髋区、前臂等,但各检测方法、检测部位测得的骨密度值及骨质疏松发病率有很大差异。定量CT是检测脊柱关节炎患者骨质疏松最为准确的方法,而腰椎侧位和股骨颈DXA则是目前国内检测脊柱关节炎患者骨质疏松最广泛和有效的方法。脊柱关节炎各分型中强直性脊柱炎患者的骨质疏松患病率高于银屑病关节炎。且骨质疏松患病率可能随病程的延长而升高。对于继发骨质疏松的治疗,除双膦酸盐等常规治疗药物,针对脊柱关节炎的TNF-α抑制剂亦有一定疗效。
[Abstract]:Spinal arthritis is a class of chronic inflammatory rheumatism characterized by the involvement of the spine and peripheral joints, or joints, ligaments, and tendons. The main clinical symptoms are inflammatory backache, asymmetric peripheral oligoarthritis, and inflammation of the starting and ending points. And certain organ lesions such as anterior uveitis, psoriasis and chronic inflammatory bowel disease. Osteoporosis and low bone mass are common in patients with spinal arthritis. BMD is the most common complication of spinal arthritis. At present, the main detection methods of bone mineral density include dual energy X-ray absorptiometry, calcaneal ultrasound, quantitative computed tomography (QCT) and so on. The common sites are lumbar vertebrae anteroposterior position, lumbar lateral position, femoral neck, etc. The hip area, forearm, etc., but the bone mineral density and the incidence rate of osteoporosis measured by each testing method, the measured site are very different. Quantitative CT is the most accurate method to detect osteoporosis in patients with spinal arthritis. Lumbar lateral position and femoral neck DXA are the most widely and effective methods to detect osteoporosis in patients with spinal arthritis. The prevalence of osteoporosis in patients with ankylosing spondylitis is higher than that in patients with psoriasis. Ganglitis. And the prevalence of osteoporosis may increase with the duration of the disease. For the treatment of secondary osteoporosis, In addition to diphosphonates and other conventional treatment drugs, TNF- 伪 inhibitors for spinal arthritis also have a certain effect.
【作者单位】：复旦大学附属华山医院风湿科;复旦大学附属华山医院核医学科;
【分类号】：R593.23;R580

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