类风湿性关节炎患者骨代谢指标与骨密度相关性研究  

Study on the Correlation Between Bone Metabolism Markers and Bone Mineral Density in Patients with Rheumatoid Arthritis

作　　者：粘少硕 许文锟 卢海景 NIAN Shaoshuo;XU Wenkun;LU Haijing(Quanzhou Proper Bone Hospital,Laboratory,Quanzhou City,Quanzhou 362000,China;Quanzhou Proper Bone Hospital,Rheumatic Disease Department,Quanzhou City,Quanzhou 362000,China)

机构地区：[1]泉州市正骨医院检验科,福建省泉州市362000 [2]泉州市正骨医院风湿科,福建省泉州市362000

出　　处：《中华灾害救援医学》2025年第1期45-48,共4页Chinese Journal of Disaster Medicine

基　　金：建中医药大学校管科研课题(XB2024188)。

摘　　要：目的分析类风湿性关节炎患者骨代谢指标和骨密度的水平,并进一步探讨其相关性。方法回顾性分析2021年3月至2023年3月泉州市正骨医院收治的148例类风湿性关节炎患者的临床资料。选取同期体检的100名健康人员作为对照。采用类风湿性关节炎疾病活动度评分系统(DAS28)对类风湿性关节炎患者进行分级,比较不同级别类风湿性关节炎患者和健康对照组的Ⅰ型前胶原氨基末端肽(P1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、25-羟基维生素D(25-OHVD)、N端中段骨钙素(N-MID)水平以及骨密度水平(L1~4腰椎、股骨颈)。并利用Pearson相关性分析骨代谢指标和骨密度的相关性。结果与健康对照组相比,类风湿性关节炎Ⅱ、Ⅲ、Ⅳ级患者血清中P1NP、25-OHVD、N-MID水平较低(P<0.05),β-CTX水平较高(P<0.05);类风湿性关节炎Ⅰ级患者血清中以上骨代谢指标水平无明显差异(P>0.05)。不同级别类风湿性关节炎患者随着分级的增加,血清P1NP、25-OHVD、N-MID水平依次降低(P<0.001),β-CTX水平依次升高(P<0.001)。与健康对照组相比,类风湿性关节炎Ⅲ、Ⅳ级患者腰椎、股骨颈骨密度水平较低(P<0.05);类风湿性关节炎Ⅰ、Ⅱ级患者上述部位骨密度水平无明显差异(P>0.05)。不同级别类风湿性关节炎患者腰椎、股骨颈骨密度水平,随着分级的增加,骨密度水平依次降低(P<0.001)。经Pearson相关性分析,类风湿性关节炎患者血清中P1NP、25-OHVD、N-MID水平与骨密度水平呈正相关(γ>0.9,P<0.05);β-CTX水平与骨密度水平呈负相关(γ=-0.970,P<0.05)。结论血清骨代谢指标和骨密度水平可在一定程度上动态反映类风湿性关节炎患者病情的严重程度。Objective Analyze the levels of bone metabolism indicators and bone density in patients with rheumatoid arthritis,and further explore their correlation.Methods A retrospective analysis was conducted on the clinical data of 148 patients with rheumatoid arthritis admitted to Quanzhou Orthopedic Hospital from March 2021 to March 2023.Select 100 healthy individuals who underwent physical examinations during the same period as controls.The Disease Activity Rating System for Rheumatoid Arthritis(DAS28)was used to grade patients with rheumatoid arthritis.The levels of type I procollagen N-terminal peptide(P1NP),type I collagen carboxyterminal peptide beta special sequence(β-CTX),25 hydroxyvitamin D(25-OHVD),N-terminal midpiece osteocalcin(N-MID),and bone density(L1-4 lumbar vertebrae,femoral neck)were compared between patients with different grades of rheumatoid arthritis and a healthy control group.And use Pearson correlation analysis to investigate the correlation between bone metabolism indicators and bone density.Results Compared with the healthy control group,patients with rheumatoid arthritis grades II,III,and IV had lower levels of P1NP,25-OHVD,and N-MID in their serum(P<0.05),and higher levels ofβ-CTX(P<0.05);There was no significant difference in the levels of the above bone metabolism indicators in the serum of rheumatoid arthritis grade I patients(P>0.05).As the grading of rheumatoid arthritis increases,the levels of serum P1NP,25-OHVD,and N-MID decrease sequentially(P<0.001),while the levels ofβ-CTX increase sequentially(P<0.001).Compared with the healthy control group,patients with rheumatoid arthritis grade III and IV had lower bone density levels in the lumbar spine and femoral neck(P<0.05);There was no significant difference in bone density levels between patients with rheumatoid arthritis grade I and II in the above-mentioned areas(P>0.05).The bone mineral density levels of lumbar spine and femoral neck in patients with different grades of rheumatoid arthritis decrease sequentially with the increase

关 键 词：关节炎 类风湿 骨密度 相关性分析 

分 类 号：R593.22[医药卫生—内科学]