类风湿关节炎患者骨质疏松症患病及治疗现状  

Investigation about prevalence and treatment of osteoporosis in patients with rheumatoid arthritis

作　　者：关欣[1] 王秀茹[1] 王宽婷[1] 韩淑玲[1] 丁艳[1] 董红宇[2] 

机构地区：[1]北京大学首钢医院风湿免疫科,北京100144 [2]首都医科大学教学医院北京市石景山医院风湿免疫科,北京100043

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2016年第1期22-26,共5页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：北京市优秀人才培养资助项目(2013A008006000001)

摘　　要：目的调查和分析门诊类风湿关节炎患者骨质疏松症患病及治疗情况。方法选择类风湿关节炎患者141例（年龄均〉50岁）,女性106例,男性35例。采用双光能X射线骨密度测量仪测定股骨颈和腰椎1～4骨密度,同时记录患者基础资料、疾病特征和类风湿关节炎治疗情况,评价疾病活动性,并对所有患者进行现场调查,内容包括是否有脆性骨折病史,以及预防性或治疗性应用骨质疏松药物情况。结果确诊骨质疏松症43例,患病率为30.5%。其中男性6例,患病率为17.1%;女性37例,患病率为34.9%。女性、老龄、病程长、临床的疾病活动指数（Clinical Disease Activity Index,CDAI）高分是类风湿关节炎患者发生骨质疏松的危险因素;应用改善病情药物对类风湿关节炎进行规范治疗是保护性因素。并发骨质疏松症的类风湿关节炎患者中近1年内未接受骨质疏松药物治疗23例,占53.5%;6例有脆性骨折病史,占14.0%,其中3例未曾接受过骨质疏松药物治疗。结论类风湿关节炎合并骨质疏松症发生率高,但是超过半数的患者未接受正规抗骨质疏松药物治疗或者治疗不规范。Objective To investigate the prevalence and treatment for osteoporosis in patients with rheumatoid arthritis. Methods Totally 141 cases with rheumatoid arthritis（ aged over 50 years） were included in the investigation,including 106 cases of female and 35 cases of male. Bone mineral density of femoral neck（ 1-4） and lumbar spine was measured by dual energy X-ray absorptiometry. The basic data,characteristics and the treatment of rheumatoid arthritis were recorded and the disease activity was evaluated. All patients accepted the investigation about the history of brittle fracture and prophylactic or therapeutic application of drugs for osteoporosis. Results Fourty three patients（ 30. 5 %） were diagnosed with osteoporosis, of which 6 patients were male and 37 patients were female. The incidence of osteoporosis is 17. 1 % in male and 34. 9 % in female. Female, old age, long disease course,high score of Clinical Disease Activity Index（ CDAI） are the risk factors of osteoporosis in patients with rheumatoid arthritis. The regular treatment of disease modifying anti-rheumatic drugs（ DMARDs） for rheumatoid arthritis is a protective factor. 23 cases（ 53. 5 %） did not receive any drug for osteoporosis during nearly one year; 6patients（ 14. 0 %） had brittle fracture; 3 patients had never received therapy for osteoporosis. Conclusion The incidence of osteoporosis in rheumatoid arthritis is high, but more than half of the patients do not receive the regular anti-osteoporosis treatment.

关 键 词：类风湿关节炎 骨质疏松症 现状调查 

分 类 号：R681[医药卫生—骨科学]