1051例强直性脊柱炎患者骨密度分析  

Analysis of bone mineral density in 1051 patients with ankylosing spondylitis

作　　者：孔维萍[1] 张卫[1] 陶庆文[1] 路平[1] 王昊[1] 阎小萍[1] 

机构地区：[1]中日友好医院中医风湿病科,北京100029

出　　处：《中国骨质疏松杂志》2012年第11期1036-1041,共6页Chinese Journal of Osteoporosis

摘　　要：目的研究1051例AS患者骨质疏松、骨量减少的发生率,探讨性别、年龄、病程、HLA-B27、疾病活动度等因素对AS骨质疏松发生的影响作用,探讨AS患者骨质疏松症的发生机制。方法双能X线法检测1051例AS患者、767例健康组腰椎、股骨颈、股骨粗隆BMD。并检测AS组ESR、CRP、PGA、脊柱痛、BASDAI水平。结果 1051例AS患者发现骨质疏松的发生率为34%,骨量减少的发生率为33.78%;腰椎骨质疏松率26.83%,骨量减少率为24%;股骨颈骨质疏松率7.33%,骨量减少率21.03%。AS疾病组低年龄组(20～29岁)腰椎骨密度较中(30～39岁)、高(40～45岁)年龄组显著降低;AS低年龄组的股骨颈骨密度较中年龄组显著减低。AS患者男性骨质疏松的发病率39.32%,女性患者骨质疏松的发病率11.06%。HLA-B27阳性患者的腰椎、股骨颈、股骨粗隆骨密度较阴性患者均显著降低。脊柱功能早期患者与健康对照组比较各部位骨密度显著降低(P<0.001)。AS患者的骨密度与骶髂关节炎程度、ESR、CRP呈显著负相关。结论 AS患者骨质疏松发生率高,患者在青、中年阶段、发病早、中期就已出现腰椎和股骨骨密度的减低,男性AS骨质疏松的发生率高于女性,HLA-B27阳性患者骨质疏松发生率高于HLA-27阴性患者,废用并不是导致AS患者骨质疏松的主要原因,但可能是使骨质疏松程度加重的原因,AS骨质疏松的发生与疾病炎症活动度、骶髂关节炎程度相关。Objective To study the incidence of osteopenia and osteoporosis in 1051 patients with ankylosing spondylitis （AS）, to investigate the effect of gender, age, duration of disease, HLA-B27, and the activity of disease on the genesis of osteoporosis associated with AS, and to explore the mechanism of osteoporosis in patients with AS. Methods Bone mineral density （BMD） of the lumbar vertebrae, the femoral neck, and the femoral trochanter of 1051 patients with AS and 767 subjects in healthy control group was measured using DEXA. Levels of erythrocyte sedimentation rate （ESR） , C-reactive protein （CRP） , PGA, rachialgia, and BASDAI was measured in AS group. Results The total incidence of osteoporosis and osteopenia in 1051 AS patients was 34% and 33.78% , respectively. The incidence of osteoporosis and osteopenia in the lumbar vertebrae and the femoral neck was 26.83% and 24% , 7.33% and 21.03% , respectively. BMD of the lumbar vertebrae of the patients in AS lower-age group （20 - 29 years） was significantly lower than that in middle-age group （30 -39 years） and the elder group （40 -45 years）. B MD of the femoral neck in AS lower age group was significantly lower than that in middle age group. The incidence of osteoporosis in male and female AS patients was 39. 32% and 11.06% , respectively. BMD of the lumbar vertebrae, the femoral neck, and the femoral trochanter in HLA-B27 positive patients was significantly lower than that in HLA-B27 negative patients. BMD of AS patients in early stage with no decline of spinal function was significantly lower than that in control group （P 〈 0.001 ）. BMD of patients with ASwas significantly negatively correlated with the extent of sacroiliitis, ESR, and CRP. Conclusion The incidence of osteoporosis in AS patients is high. Patients in young, middle-aged stage, early onset, and middle term have showed a reduction of BMD of the lumbar vertebrae and the femur. The incidence of osteoporosis in male AS patients is higher than that in female AS patients. Th

关 键 词：强直性脊柱炎 骨密度 骨质疏松 

分 类 号：R681[医药卫生—骨科学] R181.38[医药卫生—外科学]