强直性脊柱炎合并髋关节累及患者骨质疏松症发病概况及相关因素分析

发布时间：2018-02-23 22:13

本文关键词： 强直性脊柱炎骨质疏松骨密度髋关节　出处：《中国骨质疏松杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的研究强直性脊柱炎(ankylosing spondylitis,AS)合并髋关节累及患者骨质疏松症的发病概况、特点及相关因素。方法收集有髋关节受累的AS患者82例,并以80名健康体检者作为对照。收集患者的临床资料,包括胸腰椎及骨盆X线、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白水平(C-reactive protein,CRP)、HLA-B27、强直性脊柱炎疾病活动指数(bath ankylosing spondylitis disease activity index,BASDAI)、强直性脊柱炎Bath功能指数、强直性脊柱炎放射学指数及治疗情况等。双能X线检测骨密度(bone mineral density,BMD),测量部位为腰椎1~4和股骨颈部位。结果 AS合并髋关节累及的患者骨量减少或骨质疏松发生率(78.05%)明显高于健康对照组(32.5%);与正常对照组比较,AS组表现出更高的骨量减少(46.3%VS 27.5%)和骨质疏松发生率(31.7%VS 5.0%)。但AS患者骨密度检测率及抗骨质疏松治疗率极低。合并髋关节受累的AS患者腰椎及股骨颈部位骨密度水平均明显低于正常对照组。相关性分析结果显示,ESR升高是AS患者腰椎骨丢失的危险因素;而身高、体重、BASDAI及CRP水平与股骨颈部位骨密度明显相关。结论 AS合并髋关节累及患者腰椎及股骨颈部位骨密度水平均明显降低;ESR及CRP水平升高、高疾病活动度是AS患者骨丢失的危险因素;AS合并髋关节累及患者骨质疏松发生率高,但骨密度检测率及抗骨质疏松治疗率极低。
[Abstract]:Objective to study the general situation, characteristics and related factors of osteoporosis in patients with ankylosing spondylitis (ASA) associated with hip involvement. Methods 82 cases of as with hip involvement were collected. The clinical data, including thoracolumbar vertebrae and pelvic X-ray, were collected from 80 healthy persons as control. Erythrocyte sedimentation rate and erythrocyte sedimentation rate.ESR C reactive protein level, HLA-B27, activity index of ankylosing spondylitis, disease activity index, Bath function index of ankylosing spondylitis. Radiologic index and treatment of ankylosing spondylitis, etc. Bone mineral density was measured by dual-energy X-ray. Results Bone mass decrease or osteoporosis occurred in patients with as complicated with hip involvement. The rate of 78.05) was significantly higher than that of the healthy control group (32.5%); compared with the normal control group, the as group showed a higher reduction in bone mass (46.3 vs 27.5m) and the incidence of osteoporosis (31.7VS 5.0%). However, the BMD test rate and the anti-osteoporosis treatment rate in as patients were very low. The bone mineral density of lumbar vertebrae and femoral neck in as patients with involvement was significantly lower than that in normal controls. The correlation analysis showed that the increase of ESR was the risk factor of lumbar bone loss in as patients. Height, body weight, BASDAI and CRP levels were significantly correlated with bone mineral density of femoral neck. Conclusion BMD levels of lumbar vertebrae and femoral neck in patients with as complicated with hip involvement were significantly lower than those in patients with hip involvement. High disease activity is the risk factor of bone loss in as patients. The incidence of osteoporosis in patients with as complicated with hip involvement is high, but the detection rate of bone mineral density and the treatment rate of anti-osteoporosis are very low.
【作者单位】：上海交通大学医学院附属仁济医院风湿科;
【基金】：上海市重点学科建设项目(T0203) 上海市临床医学中心211项目
【分类号】：R580;R593.23

【相似文献】