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目的探讨绝经前女性类风湿关节炎(RA)患者骨密度(BMD)和骨质疏松(OP)的发生情况,并分析其与各临床指标的相关性。方法采用超声骨密度仪测量100例绝经前女性RA患者及50例绝经前健康对照者右侧足跟部位的BMD,分析BMD的变化。结果 1RA组BMD显著低于对照组(P<0.01),且其OP发生率较对照组明显升高(P<0.01),影响因素有:激素、维生素D、疾病活动、关节功能及影像学进展;2RA患者BMD与ESR,CRP,RF,DD呈负相关,与25(OH)D3、血钙水平呈正相关(P均<0.05);而与抗CCP,IgG,IgA,IgM,C3,C4等均无相关性。结论 RA患者较正常人群BMD明显降低,OP发生率升高,BMD与维生素D水平及疾病活动程度密切相关,可作为RA骨质破坏及病情进展的预测指标,亦可指导临床治疗。
Objective To investigate the incidence of osteoporosis (BMD) and osteoporosis (OP) in premenopausal women with rheumatoid arthritis (RA) and to analyze its correlation with various clinical parameters. Methods BMD of 100 cases of premenopausal women with RA and 50 cases of right meniscus before menopause were measured by using ultrasonic bone densitometry. The changes of BMD were analyzed. Results The BMD of 1RA group was significantly lower than that of control group (P <0.01), and the incidence of OP was significantly higher than that of control group (P <0.01). The influencing factors were hormone, vitamin D, disease activity, joint function and imaging progress ; BMD of patients with 2RA was negatively correlated with ESR, CRP, RF, DD and positively correlated with 25 (OH) D3 and serum calcium (P <0.05), but not with CCP, IgG, IgA, IgM, C3, C4 No correlation. Conclusion The BMD of RA patients is significantly lower than that of normal people, and the incidence of OP is increased. BMD is closely related to the level of vitamin D and the degree of disease activity. It can be used as a predictor of bone destruction and progression of RA, and also guide the clinical treatment.