系统性红斑狼疮患者骨密度和骨代谢水平及其临床意义  

Bone mineral density and bone metabolism and their clinical significance in patients with systemic lupus erythematosus

作　　者：史伟 芮金兵[1] 裘影影[1] 王燕茹[1] 邓家良[1] 汤郁[1] SHI Wei;RUI Jinbing;QIU Yingying(Department of Rheumatology,Affiliated Hospital,Jiangsu University,Zhenjiang 212001,CHINA)

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：《江苏医药》2022年第3期288-292,共5页Jiangsu Medical Journal

摘　　要：目的探讨系统性红斑狼疮(SLE)患者骨密度和骨代谢水平及其临床意义。方法采用双能X射线吸收测定法测定69例SLE患者(SLE组)和61例健康志愿者(C组)腰椎和股骨颈处骨密度,采用化学发光免疫分析法检测两组血清骨钙素、Ⅰ型原胶原N端前肽(PINP)和Ⅰ型胶原C端交联肽(CTX)水平。比较两组骨密度和骨代谢标志物水平,分析SLE组骨密度和骨代谢标志物与临床指标的相关性。结果SLE组PINP和骨钙素水平均低于C组(P<0.01)。SLE组腰椎骨密度与年龄、累积激素用量呈正相关(P<0.05);股骨颈骨密度与维生素D呈正相关,与SLE疾病活动度评分(SLEDAI)、双链DNA(dsDNA)呈负相关(P<0.05);CTX与ESR、CRP呈正相关(P<0.05);PINP与ESR呈正相关,与病程、SLEDAI、dsDNA、累积激素用量呈负相关(P<0.05);骨钙素与年龄呈正相关,与病程、累积激素用量呈负相关(P<0.05)。结论SLE患者低骨量和骨代谢异常与病程、年龄、激素使用量、维生素D、SLEDAI、dsDNA、ESR和CRP相关。Objective To investigate the bone mineral density(BMD)and bone metabolism and their clinical significance in the patients with systemic lupus erythematosus(SLE).Methods The BMD of lumbar spine and femoral neck in 69 SLE patients(group A)and 61 healthy volunteers(group C)were measured by dual-energy X-ray absorptiometry.Serum levels of osteocalcin(OC),typeⅠprocollagen N-terminal propeptide(PINP)and typeⅠcollagen C-terminal cross-linking peptide(CTX)were measured by chemiluminescence immunoassay.The levels of BMD and bone metabolic markers were compared between the two groups,and the correlation of BMD and bone metabolic markers with clinical indexes in group A was analyzed.Results The levels of PINP and OC in group A were lower than those in group C(P<0.01).Lumbar spine BMD was positively correlated with age and cumulative glucocorticoid dose(P<0.05),femoral neck BMD was positively correlated with vitamin D and negatively correlated with SLE disease activity index(SLEDAI)and dsDNA(P<0.05),CTX was positively correlated with ESR and CRP(P<0.05),PINP was positively correlated with ESR and negatively correlated with course of disease,SLEDAI,dsDNA and cumulative glucocorticoid dose(P<0.05),OC was positively correlated with age and negatively correlated with course of disease and cumulative glucocorticoid dose(P<0.05)in group A.Conclusion Low bone mass and abnormal bone metabolism in SLE patients are related to the course of disease,age,glucocorticoid usage,vitamin D,SLEDAI,dsDNA,ESR and CRP.

关 键 词：系统性红斑狼疮 骨钙素 Ⅰ型原胶原N端前肽 Ⅰ型胶原C端交联肽 骨密度 

分 类 号：R593[医药卫生—内科学]