肝肾阴虚型类风湿关节炎与骨质疏松相关性研究

发布时间：2018-06-25 20:15

本文选题：关节炎 + 类风湿　；参考：《中国骨质疏松杂志》2017年02期

【摘要】：目的探究肝肾阴虚型类风湿关节炎患者骨质疏松的发生情况,从相关实验室指标分析其相关性并预测继发性骨质疏松的危险因素及发生情况。方法选取符合标准的肝肾阴虚型类风湿关节炎的病人。进行常规血细胞分析、血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(Ig ARF Ig MRF,Ig GRF)、抗环瓜氨酸肽抗体(抗CCP抗体)检测、骨代谢指标检查和骨密度(BMD)检查。使用多种统计学方法分析其相关性并预测危险因素。结果共选取符合标准的肝肾阴虚型RA患者64人。其中骨质疏松患者共30人,占46.88%。明显较湿热痹阻型RA发生率(18.18%)高。BMD与抗CCP抗体数值相关,骨质疏松的患者抗CCP抗体较高;血红蛋白数值与BMD有关,骨量正常组的血红蛋白数值较高。急性炎症指标与PTH水平呈显著负相关关系,Ig MRF、抗CCP抗体、PTH水平与髋部BMD水平呈现明显的负相关关系。年龄大于65岁患者较其他患者髋部骨质疏松的风险多约一倍;血沉异常患者的腰椎及髋部骨质疏松的发生率均为血沉正常患者的10倍左右;抗CCP抗体高滴度患者腰椎骨质疏松的发生率为其他患者的7倍、髋部骨质疏松的发生率为其他患者的9倍余。结论年龄、ESR、抗CCP抗体水平与BMD值关系密切,均为继发骨质疏松的危险因素,其中年龄大于65岁,ESR、抗CCP抗体水平较高、血红蛋白水平较低的RA肝肾阴虚型患者,即RA控制不佳的肝肾阴虚型患者更易患继发性骨质疏松。
[Abstract]:Objective to investigate the incidence of osteoporosis in patients with rheumatoid arthritis with deficiency of liver and kidney yin, analyze its correlation with relevant laboratory indexes and predict the risk factors and occurrence of secondary osteoporosis. Methods patients with rheumatoid arthritis of liver and kidney yin deficiency type were selected. Routine blood cell analysis, erythrocyte sedimentation rate (ESR) C-reactive protein (CRP), rheumatoid factor (Ig ARF Ig MRFG GRF), anti-cyclic citrullinated peptide antibody (anti-CCP), bone metabolism and bone mineral density (BMD) were performed. Multiple statistical methods were used to analyze the correlation and predict risk factors. Results A total of 64 RA patients with liver and kidney yin deficiency type were selected. There were 30 patients with osteoporosis, accounting for 46.88. The incidence rate of RA was significantly higher than that of damp-heat obstruction type (18.18%). BMD was correlated with the value of anti-CCP antibody, and that of patients with osteoporosis was higher than that of patients with osteoporosis, and the value of hemoglobin was related to BMD, and the value of hemoglobin in the group with normal bone mass was higher than that in the group with normal bone mass. There was a significant negative correlation between acute inflammation and PTH level, and significant negative correlation between anti-CCP antibody PTH level and hip BMD level. The risk of osteoporosis in patients over 65 years of age was about twice as high as that in other patients, and the incidence of osteoporosis in lumbar vertebrae and hip in patients with abnormal ESR was about 10 times as high as that in patients with ESR. The incidence of osteoporosis in lumbar vertebrae in patients with high titer of anti-CCP antibody was 7 times of that in other patients, and the incidence of osteoporosis in hip was more than 9 times of that in other patients. Conclusion ESR, anti-CCP antibody level and BMD level are closely related to BMD, and they are all risk factors of secondary osteoporosis, especially in RA patients with liver and kidney yin deficiency, who are older than 65 years old, with higher anti-CCP antibody level and lower hemoglobin level. That is to say, patients with deficiency of yin and deficiency of liver and kidney are more likely to suffer from secondary osteoporosis.
【作者单位】：扬州大学医学院;江苏省中西医结合老年病防治重点实验室;上海光华中西医结合医院;
【基金】：国家自然科学基金资助项目(81272537,30801497) 江苏省高校自然科学基金资助项目(11KJB360010) 扬州大学新世纪创新人才项目资助
【分类号】：R593.22;R580

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