强直性脊柱炎合并骨密度异常患者危险因素分析  

Analysis of risk factors in patients with ankylosing spondylitis complicating abnormal bone mineral density

作　　者：刘雷 洪学志 李啸天[2] 姜玉欣 许佳[1] 莫汉有[1] LIU Lei;HONG Xuezhi;LI Xiaotian;JIANG Yuxin;XU Jia;MO Hanyou(Department of Rheumatology,Affiliated Hospital of Guilin Medical College,Guilin,Guangxi 541001,China;Department of Imaging,Affiliated Hospital of Guilin Medical College,Guilin,Guangxi 541001,China)

机构地区：[1]桂林医学院附属医院风湿免疫科,广西桂林541001 [2]桂林医学院附属医院影像科,广西桂林541001

出　　处：《重庆医学》2021年第21期3643-3646,共4页Chongqing medicine

基　　金：国家自然科学基金项目(81760298)。

摘　　要：目的探讨首诊强直性脊柱炎(AS)合并骨密度(BMD)异常患者的临床特点及危险因素。方法回顾性分析2014年1月至2020年6月首次于该院风湿免疫科确诊为AS患者83例,其中男69例,女14例;中位年龄29(26,37)岁。统计分析患者BMD值、年龄、病程、身高、体重、炎症标记物、骨代谢指标等。结果83例患者中骨量减少63例(75.9%),骨质疏松(OP)24例(28.9%),脆性骨折2例(2.4%);BMD值与红细胞沉降率、碱性磷酸酶、β-胶原特殊序列呈负相关,与总25羟维生素D[25(OH)D]呈正相关;长病程组患者体重指数(BMI)、BMD值与短病程组比较,差异均有统计学意义(P<0.05)。结论AS患者早期即可出现OP,疾病高活动度、β-胶原特殊序列、低BMI及低总25(OH)D是发生OP的危险因素。Objective To explore the clinical characteristics and risk factors in the patients with ankylosing spondylitis(AS)complicating abnormal bone mineral density(BMD).Methods Eighty-three patients with AS initially diagnosed in the rheumatology and immunology department of this hospital from January 2014 to June 2020 were analyzed retrospectively,including 69 males and 14 females,with a median age of 29(26,37)years old.The measured values of BMD,age,course of disease,height,weight,inflammatory markers and bone metabolic indexes were statistically analyzed.Results Among 83 cases of AS,the bone mass decrease was in 63 cases(75.9%),osteoporosis(OP)in 24 cases(28.9%)and fragility fracture in 2 cases(2.4%).The BMD value was negatively correlated with ESR,alkaline phosphatase andβ-collagen specific sequence,and positively correlated with the total 25(OH)vitamin D.There were statistically significant differences in the values of BMI and BMD between the long course group and short course group(P<0.05).Conclusion OP can appear in the early stage of AS.The high disease activity,special sequence ofβ-collagen,low BMI and low total 25(OH)vitamin D are the risk factors for OP occurrence.

关 键 词：强直性脊柱炎 骨质疏松 危险因素 

分 类 号：R593.23[医药卫生—内科学]