强直性脊柱炎发生脊柱骨折的危险因素及与骨代谢指标相关性分析  

Risk factors of spinal fractures in ankylosing spondylitis patients and their correlation with bone metabolism indexes

作　　者：王晓林[1] 曾凡伟[1] 陈芳[1] WANG Xiao-lin;ZENG Fan-wei;CHEN Fang(Dazhou Central Hospital,Dazhou 635000,China)

机构地区：[1]四川省达州市中心医院,四川达州635000

出　　处：《实用医院临床杂志》2020年第3期218-221,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫计委科研基金资助项目(编号:17PJ065)。

摘　　要：目的探讨强直性脊柱炎(AS)发生脊柱骨折的危险因素及与骨代谢指标相关性。方法2016年10月至2018年12月我院收治的80例AS脊柱骨折患者为研究组,另选取同期我院收治的AS但未发生脊柱骨折的患者60例为对照组,对两组临床资料进行分析,探讨AS患者发生脊柱骨折的危险因素及其与骨代谢指标的相关性。结果两组骨代谢指标比较,研究组甲状旁腺激素(PTH)、骨钙素(BGP)明显低于对照组(P<0.05),I型前胶原氨基端前肽(PINP)、抗酒石酸酸性磷酸酶(TRAP-5b)和β-异构C-端肽(β-CTx)高于对照组(P<0.05);两组指-地距离、Schober指数、腰椎骨密度(BMD)、跌落创伤史、股骨颈BMD方面比较,差异有统计学意义(P<0.05);股骨颈BMD<0.70 g/cm3是AS患者出现脊柱骨折的独立危险因素(P<0.05),且研究组股骨颈BMD与血清PINP、TRAP-5b水平有明显负相关性(P<0.05)。结论股骨颈BMD<0.70 g/cm3是AS患者出现脊柱骨折的独立危险因素,并与血清PINP和TRAP-5b水平呈明显负相关性。Objective To explore the risk factors of ankylosing spondylitis(AS)spinal fractures and their correlation with bone metabolism indexes.Methods A total of 80 patients with AS spinal fractures who were admitted to our hospital from October 2016 to December 2018 were enrolled as study group.In addition,60 AS patients without spinal fractures who were admitted to our hospital were enrolled as control group.Univariate and multivariate logistic regression analysis were performed on clinical data in both groups.The high-risk factors of spinal fractures in AS patients were determined.Their correlation with bone metabolism indexes was analyzed.Results PTH and BGP were significantly lower while PINP,TRAP-5 b andβ-CTx were higher in the study group than those in the control group(P<0.05).The comparison results of general data and clinical indexes between the two groups showed that there were significant differences in finger-ground distance,Schober index,lumbar BMD,history of falling trauma and femoral neck BMD between the two groups(P<0.05).The results of multivariate logistic regression analysis showed that femoral neck BMD less than 0.70 g/cm3 was an independent risk factor for spinal fracture in AS patients(P<0.05).There was significant negative correlation between femoral neck BMD and serum PINP and TRAP-5 b levels in the study group(P<0.05).Conclusion BMD less than 0.70 g/cm3 of femoral neck is an independent risk factor for spinal fractures in AS patients,which is significantly negatively correlated with serum PINP and TRAP-5 b levels.

关 键 词：强直性脊柱炎 脊柱骨折 危险因素 骨代谢 相关性 

分 类 号：R681.51[医药卫生—骨科学]