原发性干燥综合征患者的骨代谢变化及影响因素  

Bone Metabolism Changes and Influencing Factors in Patients with Primary Sjogren Syndrome

作　　者：娄方明 锁星星 裘影影[1] 芮金兵[1] 王燕茹[1] 李晶[1] 汤郁[1] LOU Fang-ming;SUO Xing-xing;QIU Ying-ying(Department of Rheumatology,the Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001)

机构地区：[1]江苏大学附属医院风湿免疫科,江苏镇江212001

出　　处：《医学临床研究》2020年第4期495-498,共4页Journal of Clinical Research

基　　金：国家自然科学基金项目(81571582)。

摘　　要：[目的]探讨原发性干燥综合征(pSS)患者的骨质状况及影响患者骨量的相关因素.[方法]选取pSS患者55例作为观察组,健康体检者50例作为对照组.比较两组腰椎、股骨颈的骨密度(BMD)及Ⅰ型胶原C端肽交联(CTX)、Ⅰ型原胶原N端前肽(PINP)和骨钙素(OC)水平,分析其与年龄、病程、血沉(ESR),C反应蛋白(CRP)、补体C3、补体C4、血清补体C1q、激素使用情况的相关性,并比较pSS患者BMD与骨代谢指标.[结果]pSS患者腰椎、股骨颈BMD及PINP、OC水平均低于对照组,CTX水平高于对照组,且差异均有显著性(P<0.05).pSS患者腰椎及股骨颈的BMD与其年龄、补体C1q呈负相关,且腰椎BMD与激素用量呈负相关(P<0.05);pSS患者CTX水平与补体C4呈负相关(P<0.05),与激素用量呈正相关(P<0.05);PINP、OC水平与CRP、激素用量呈负相关,而OC水平与补体C4呈正相关(P<0.05).pSS患者中骨量减少组、骨质疏松组的CTX水平高于骨量正常组,骨质疏松组PINP、OC水平低于骨量正常组,骨量正常的pSS患者PINP、OC水平较正常对照组降低(P<0.05).[结论]pSS患者存在BMD和骨代谢异常,并与疾病活动和激素用药有关.骨代谢指标可评估骨量正常pSS患者的骨质状况.[Obiective]To investigate the bone status,influencing factors associated with bone mass,and bone metabolism markers during bone mass changes in patients with primary Sjogren syndrome(pSS).[Methods]A total of 55 patients with pSS were selected as the observation group and 50 healthy volunteers were recruited as the control group.The bone mineral density(BMD)of lumbar vertebrae and femoral neck and the bone metabolic markers such as type Ⅰ collagen C-terminal peptide cross linking(CTX),type Ⅰ procollagen N-terminal propeptide(PINP)and osteocalcin(OC)of the two groups were compared.The correlations of bone metabolic markers with age,duration of disease,body mass index,erythrocyte sedimentation rate (ESR).C-reactive protein(CRP),complement(C3,C4 and C1q)and hormone usage were analyzed,The relationship between BMD and bone metabolism markers in patients with pSS was evaluated as well.[Results]The levels of BMD,PINP and OC of lumbar vertebrae and femoral neck in pSS group were lower than those in the control group,while the level of CTX in pSS group was higher than that in control group(P<0.05).The BMD of lumbar vertebrae and femoral neck in pSS group were negatively correlated with age and C1q;and the BMD of lumbar vertebrae was also negatively correlated with hormone usage(P<0.05).The level of CTX in pSS group was negatively correlated with C4(P<0.05)and positively correlated with hormone usage(P<0.05).The levels of PINP and OC in patients with pSS were negatively correlated with the levels of CRP and hormone usage,while the level of OC was positively correlated with C4 level(P<0.05).The level of CTX in pSS patients with osteopenia group and osteoporosis subgroup was higher than that in pSS subgroup with normal bone mass;and the levels of PINP and OC in osteoporosis subgroup were lower than those in normal bone mass subgroup.Compared to the control group,the levels of PINP and OC in normal bone mass subgroup of pSS were lower;and the diference was stistically significant(P<0.05).[Conclusion]Patients with pSS have

关 键 词：干燥综合征 骨密度 

分 类 号：R777.2[医药卫生—眼科]