绝经后女性膝骨关节炎的骨量变化  

Clinical research in bone mass change of postmenopausal women patients with knee osteoarthritis

作　　者：张向群[1] 李敏[2] 吴晓惠[2] 蔚浩 钟家芳[3] 

机构地区：[1]成都市老年病医院风湿免疫科,四川成都611130 [2]四川省骨科医院风湿骨关节科,四川成都610041 [3]成都市老年病医院康复科,四川成都611130

出　　处：《临床荟萃》2012年第2期118-121,共4页Clinical Focus

摘　　要：目的探讨绝经后女性膝骨关节炎(knee osteoarthritis,KOA)患者骨量变化相关因素。方法收集参研医院100例绝经后女性KOA住院患者一般情况、血液生化、骨代谢指标血清碱性磷酸酶(ALP)、骨钙素(OC)、β胶原特殊序列(β-crosslaps)及骨密度、X线、MRI影像学、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分等临床资料,分析绝经后女性KOA患者骨量变化相关因素。结果①100例绝经后KOA女性骨质疏松症(OP)发生率23.0%(23/100),骨量减少发生率50.0%(50/100)。②绝经后女性KOA骨量与体质量指数(BMI)、高密度脂蛋白胆固醇(HDL-C)呈正相关(P<0.05),与年龄、血尿酸(UA)、OC、β-crosslaps呈负相关(P<0.05)。③BMI、HDL-C在骨质疏松症组低于骨量减少组(P<0.05),骨量减少组低于骨量正常组(P<0.05)。④UA、OC、β-Crosslaps在骨质疏松症组高于骨量减少组(P<0.05),骨量减少组高于骨量正常组(P<0.05)。ALP骨质疏松症组低于骨量减少组和骨量正常组(P<0.05)。⑤依据X线片Kellgen和Lawrence诊断分级标准,绝经后女性KOA的X线片分级Ⅱ与Ⅲ、Ⅲ与Ⅳ级之间骨量变化有统计学意义(P<0.05)。结论绝经后女性KOA患者骨量受多因素影响,其骨量变化与BMI、HDL-C呈正相关,与年龄、UA、OC、β-Crosslaps呈负相关;绝经后女性KOA骨量减少具有高转换型骨代谢特点,患者骨量变化随X线分级病情从轻到重并非线性变化规律,而是呈曲线波动。Objective To explore relative factors of bone mass change in postmenopausal women patients with knee osteoarthritis（KOA）. Methods The data of 100 postmenopausal women hospitalized patients with KOA from different research hospitals were collected,including general status,blood biochemical markers,bone metabolism serum indexes of alkaline phosphatase（ALP）,osteocalcin（OC）,β-collagen specific sequences（β-crosslaps） and bone mineral density,X-ray,MRI imaging,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC） score and other clinical information;the relative factors,bone mass change in postmenopausal women with KOA were analyzed. Results ①Osteoporosis（OP） rate in 100 cases of postmenopausal women patients with KOA was 23.0%,bone loss rate was 50.0%.②Bone mass in postmenopausal women patients with KOA was positive correlated with body mass index（BMI）,high-density lipoprotein cholesterol（HDL-C）（P〈0.05）,but negative correlated with age,blood uric acid（UA）,OC,β-crosslaps（P〈0.05）.③BMI,HDL-C in osteoporosis group were significantly lower than those in the slowdown group（P〈0.05）,and the two items in the slowdown group were lower than those in the normal group（P〈0.05）.④UA,OC,β-crosslaps in osteoporosis group were significantly higher than those in the slowdown group（P〈0.05）,and the three items in the slowdown group were significantly higher than those in the normal group（P〈0.05）.ALP in osteoporosis group was lower than that in the slowdown group and the normal group（P〈0.05）.⑤Based on Kellgen and Lawrence X-ray films in the grade diagnosis,the bone mass change in postmenopausal women with KOA had statistical significance among X-ray films grading Ⅱ and Ⅲ,Ⅲ and Ⅳ（P〈0.05）. Conclusion Postmenopausal women patients with KOA were affected by many factors in the bone mass,the bone mass is positive correlated BMI,HDL-C,but negative correlated with age,UA,OC,beta crosslaps.Bone loss in postmenopausal women with

关 键 词：骨关节炎 膝 骨质疏松 绝经后 骨质吸收 

分 类 号：R684.3[医药卫生—骨科学]