绝经后类风湿关节炎女性骨吸收与放射学进展相关

发布时间：2018-10-15 18:33

【摘要】：目的探讨绝经后类风湿关节炎(rheumatoid arthritis,RA)患者骨代谢指标与疾病活动指标、骨矿物质密度(bone mineral density,BMD)和放射学进展的相互关系。方法本研究共募集了68例绝经后RA患者。血清检测指标包括红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)和抗环胍氨酸肽抗体(CCP)。同时检测了钙、维生素D、骨碱性磷酸酶(BAP)和β胶原特殊序列(β-crosslaps)的水平。采用双能X线骨吸收仪(DXA)测量腰椎和左股骨颈的BMD(g/cm2)。DAS28和Sharp评分分别用于计算疾病活动度和放射学进展评估。运用Spearman相关分析对临床血清标记和疾病指标的相关性进行分析。结果纳入患者的异常BMD比率为94.12%,其中29.41%(20/68)为骨量减少,而64.71%(44/68)为骨质疏松。ESR、CRP和DAS28之间显著相关(P0.05),均提示疾病活动。血清β-crosslaps水平与任一疾病活动指标均无相关性(p均0.05),但与Sharp评分呈正相关(r=0.776,P=1×10-6)。结论绝经后RA患者骨量减少及骨质疏松现象突出,可能与疾病活动和/或关节结构破坏有关。β-crosslaps是与放射学进展相关而与疾病活动无关的有价值的血清标记。
[Abstract]:Objective to investigate the relationship between bone metabolism, disease activity, bone mineral density (bone mineral density,BMD) and radiologic progression in postmenopausal rheumatoid arthritis (rheumatoid arthritis,RA). Methods 68 postmenopausal RA patients were recruited. Serum parameters include erythrocyte sedimentation rate, (ESR), C reactive protein, (CRP), rheumatoid factor (RF), and anti-cyclic guanidine peptide antibody, (CCP). The levels of calcium, vitamin D, bone alkaline phosphatase (BAP) and 尾-collagen specific sequence (尾-crosslaps) were also determined. The BMD (g/cm2) of lumbar spine and left femoral neck were measured by dual energy X-ray absorptiometry (DXA). The DAS28 and Sharp scores were used to calculate the disease activity and evaluate the radiologic progress, respectively. The correlation between clinical serum markers and disease indexes was analyzed by Spearman correlation analysis. Results the ratio of abnormal BMD was 94.12 and 29.41% (20 / 68) was decreased, while 64.71% (44 / 68) was osteoporosis. There was a significant correlation between ESR,CRP and DAS28 (P0.05). There was no correlation between serum 尾-crosslaps level and any disease activity index (p 0. 05), but a positive correlation between 尾-crosslaps level and Sharp score (r = 0. 776) (1 脳 10 ~ (-6). Conclusion the phenomenon of osteopenia and osteoporosis in postmenopausal RA patients may be related to disease activity and / or destruction of joint structure. 尾-crosslaps is a valuable serum marker associated with radiologic progression but not with disease activity.
【作者单位】：香港大学深圳医院风湿免疫科;香港大学深圳医院临床生化实验室;香港大学深圳医院放射科;
【基金】：广东省省级科技计划项目(2014A020212617) 广东省医学科学技术研究基金项目(A2015395) 深圳市科技计划项目(JCYJ20150331142757389)
【分类号】：R593.22;R580

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