药物对类风湿关节炎患者骨密度的影响  

The study between the medicine and BMD of rheumatoid arthritis patients

作　　者：王彦焱[1] 赵春梅[1] 魏丽[1] 古丽仙.艾尔肯 贾娜[1] 

机构地区：[1]新疆医科大学第一附属医院骨内科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2010年第2期172-175,共4页Journal of Xinjiang Medical University

摘　　要：目的探讨类风湿关节炎(RA)患者在治疗过程中药物对骨密度(BMD)的影响。方法采用双能X线骨密度仪,测量105例类风湿关节炎患者的腰椎和股骨颈的骨矿含量。结果105例类风湿关节炎患者中骨质疏松的发生率是47%。非甾体抗炎药对类风湿关节炎患者BMD无影响(P>0.05)。类风湿关节炎患者中糖皮质激素组与非糖皮质激素组间骨质疏松发生率的比较差异有统计学意义(P<0.01)。股骨颈与腰椎BMD比较显示糖皮质激素组与非糖皮质激素组间差异均具有统计学意义(P<0.01)。糖皮质激素使用小剂量组骨质疏松发生较非小剂量组多(P<0.01)。糖皮质激素长时间用药组较短时间用药组的骨质疏松发生多(P<0.01)。类风湿关节炎患者中慢作用抗风湿药组与非慢作用抗风湿药组间引起骨质疏松的比较无统计学差异(P>0.05)。结论类风湿关节炎患者的药物治疗,在应用非甾体抗炎药、糖皮质激素改善症状的同时,应加用慢作用抗风湿药,在长期治疗过程中,应尽快减少激素用量。Objective To study the changes in bone mineral density（BMD） after pharmacotherapy in patients with rheumatoid arthritis （RA）. Methods One hundred and five RA patients＇ spine and femur BMDs were measured by X-ray absorptiometry. Results The incident rates of osteoporosis were 47% in 105 RA patients. There was no significant difference （P〉0. 05） between NSAIDs usage groups and NSAIDs disuseage groups. There is significant differences in the incident rates （P 〈0.01）, spine and femur BMDs （P 〈0.01） of glucocorticoid and non- glueocorticoid groups of RA patients. The incident rate of OP in small-dosed- glucocorticoid group was higher than non-small-dosed- glucocorticoid group （P 〈0. 01）, long-term group was higher than short-term group （P 〈0. 01）. There was no significant differ-enees （P 〈 0. 05） between DMARDs usage groups and DMARDs disuseage groups. Conclusion The NSAIDs, glucocorticoid may improve symptoms in rheumatoid arthritis （RA） patient, but DMARDs should be used additionally. The dosage of glueocorticoid should be reduced in long-term therapy.

关 键 词：药物 类风湿关节炎 骨质疏松 骨密度 

分 类 号：R593.22[医药卫生—内科学]