类风湿关节炎继发骨质疏松症相关影响因素的Logistic回归分析  

Logistic regression analysis of factors influencing osteoporosis secondary to rheumatoid arthritis

作　　者：马凤云 庞琳娜 孙聪慧 MA Fengyun;PANG Linna;SUN Conghui(Department of Rheumatology and Immunology,Shijingshan Teaching Hospital of Capital Medical University,Beijing Shijingshan Hospital,Beijing 100041,China)

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院风湿免疫科,北京100041

出　　处：《中国骨质疏松杂志》2020年第7期1009-1012,共4页Chinese Journal of Osteoporosis

基　　金：首都卫生发展科研专项项目(首发2016-3-7091)。

摘　　要：目的探讨类风湿关节炎患者继发骨质疏松症(osteoporosis,OP)的情况及相关影响因素。方法选择80例类风湿关节炎(rheumatoid arthritis,RA)患者,采用双能X线骨密度仪测定前臂、腰椎L1~4、股骨颈、Ward’s区的骨密度(bone mineral density,BMD),根据BMD将患者分为骨量正常组35例、骨量减少组26例和骨质疏松组19例。采用放射免疫法测定骨代谢指标,包括骨钙素(osteocalcin,OC)、Ι型胶原交联蛋白羧基末端肽(sputum collagen cross-linking protein carboxy terminal peptide,SCTX)、骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BAP),并同时测定RA患者相关指标,包括C反应蛋白(Creactive protein,CRP)、类风湿因子(rheumatoid factor,RF)、血沉(erythrocyte sedimentation rate,ESR)。采用Logistic回归分析RA患者继发骨质疏松症的影响因素。结果女性、骨折史、老龄、使用糖皮质激素史、病程、RF为RA继发OP的危险因素,体重指数为RA继发OP的保护因素。结论性别、年龄、使用糖皮质激素史和既往骨折史为RA患者继发骨质疏松症的显著影响因素,且骨质疏松的严重程度与病程长短、疾病活动程度等有关。Objective To investigate the secondary osteoporosis and related influencing factors in patients with rheumatoid arthritis(RA).Methods Eighty RA patients were enrolled.Bone mineral density(BMD)of the total hip,lumbar vertebrae L1-4,femoral neck,and Ward's area was measured using dual-energy X-ray absorptiometry.Patients were divided into groups according to BMD.There were 35 patients in the normal group,26 patients in the bone mass reduction group,and 19 patients in the osteoporosis group.Radioimmunoassay was used to measure bone metabolism markers,including osteocalcin(OC),sputum collagen cross-linking protein carboxy terminal peptide(SCTX),bone-specific alkaline phosphatase(BAP).Meanwhile,the disease activity indicators in RA patients,including C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were measured.Logistic regression was used to analyze the influencing factors of osteoporosis(OP)in patients with RA.Results Female gender,fracture history,aging,history of taking glucocorticoids,duration of disease,and RF were risk factors for secondary OP in RA,and BMI was a protective factor for secondary OP in RA.Conclusion Gender,age,and previous fracture history are significant factors in the development of osteoporosis in patients with RA.The severity of osteoporosis is related to the length of the disease and the degree of disease activity.

关 键 词：类风湿性关节炎 骨质疏松 影响因素 Logisctic回归 

分 类 号：R593.22[医药卫生—内科学] R589.5[医药卫生—临床医学]