风湿活动度预测绝经后女性类风湿关节炎患者骨密度的研究  

The study of the prediction of osteoporosis with rheumatoid arthritis activity in postmenopausal women

作　　者：郁新迪[1] 张育[1] 李国青[1] 李慧[1] 贾捷婷[1] 孟德芳[1] 魏华[1] 

机构地区：[1]江苏省苏北人民医院风湿免疫科

出　　处：《中国骨质疏松杂志》2016年第5期556-559,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨能够预测绝经后女性类风湿关节炎(Rheumatoid Arthritis RA)患者骨质疏松的指标。方法收集100例绝经后女性RA患者一般临床资料包括年龄、病程、血沉、C反应蛋白、类风湿因子、抗环瓜氨酸肽抗体、关节疼痛数目、关节肿胀数目,采用双能量X线骨密度仪测量腰椎、股骨及全身总的平均骨密度,比较临床资料并分析可能影响骨密度的因素。结果1.绝经后女性类风湿关节炎患者骨质疏松比例为33%,骨量减少比例47%,骨量正常比例20%。2.骨质疏松组的年龄、病程、血沉、关节疼痛数目、DAS28均高于非骨质疏松组,且有统计学意义。3.采用Logistic回归分析结果显示,年龄和DAS28是绝经后女性RA患者骨密度的独立危险因素。4.骨密度T值为诊断骨质疏松的金标准绘制受试者工作曲线,计算DAS28、年龄诊断骨质疏松的切点为5.3分和59.5岁。结论风湿活动度和年龄对于绝经后女性RA患者有较强的骨质疏松预警作用。Objective To explore the factors that can predict osteoporosis in postmenopausal women with rheumatoid arthritis（ RA）. Methods The general clinical data of 100 postmenopausal women with RA were collected,including age,course of disease,erythrocyte sedimentation rate（ ESR）,C-reactive protein（ CRP）,rheumatoid factors（ RF）,anti-cyclic citrullinated peptide antibody,the number of joint pain,and the number of joint swelling. Bone mineral density（ BMD） of the lumbar vertebrae and the hip were measured using dual energy X-ray absorptiometry. The data were compared and the potential related factors were analyzed. Results（ 1） The ratio osteoporosis,osteopenia,and normal bone mass in postmenopausal women with RA were 33%,47%,and 20%,respectively.（ 2） Patients in osteoporotic group had older age,longer course,more joint pain,and higher ESR and DAS28 than those in non-osteoporotic group.（ 3） Logistic regression analysis showed that age and DAS28 were independent factors of BMD in postmenopausal women with RA.（ 4） Based on the ROC curve,the optimal cut-point of DAS28 related to osteoporosis was 5. 3. The cut-point of age was 59. 5 years old. Conclusion DAS28 and age have strong predictive effect on osteoporosis in postmenopausal women with RA.

关 键 词：绝经后 类风湿关节炎 骨密度 DAS28 年龄 

分 类 号：R68[医药卫生—骨科学]