本文選題：類風(fēng)濕關(guān)節(jié)炎 + 破骨細(xì)胞　； 參考：《廣東醫(yī)學(xué)》2017年03期

【摘要】：目的探討骨代謝產(chǎn)物在類風(fēng)濕關(guān)節(jié)炎(RA)患者血清中的濃度變化及臨床意義。方法選擇64例住院RA患者,30例同期健康體檢者為對照組。檢測患者血清:BGP、β-CTX、PINP、25-(OH)Vit D3、ESR、CRP、RF、抗-CCP抗體。計算RA患者疾病活動指數(shù)(DAS28評分);用DEXA檢測各組受試者腰椎及股骨骨密度(BMD)。用SPSS 20.0統(tǒng)計軟件分析。結(jié)果 RA組β-CTX(0.78±0.75)ng/m L,高于對照組(0.40±0.19)ng/m L,差異有統(tǒng)計學(xué)意義(P0.05);RA組PINP(51.66±33.21)ng/m L、BGP(21.98±13.94)ng/m L、(25-OH)Vit D3(19.01±9.71)ng/m L低于對照組的(67.43±24.81)ng/m L、(30±8.67)ng/m L、(38.65±8.34)ng/m L,差異有統(tǒng)計學(xué)意義(P均0.05);RA組腰椎(L2-L4)、股骨頸(N)、Ward's三角區(qū)BMD分別為(-1.52±1.60)g/cm~2、(-1.64±1.00)g/cm~2、(-2.77±1.21 g/cm~2)均低于對照組的(1.13±0.27)g/cm~2、(0.45±0.32)g/cm~2、(-0.35±0.31)g/cm~ 2,差異有統(tǒng)計學(xué)意義(P均0.05)。β-CTX與DAS 28評分呈正相關(guān)(r=0.564,P0.05),多元相關(guān)分析顯示BMD與DAS28負(fù)相關(guān)(r=-2.07,P0.05),與抗-CCP、GPI無明顯相關(guān)(P均0.05);BMD(N)與(25-OH)Vit D3呈負(fù)相關(guān)(r=-0.348,P0.05),BMD(W)與病程呈負(fù)相關(guān)(r=-0.348,P0.05);PINP與RF、CRP、CCP、ESR無明顯相關(guān)(P均0.05)。結(jié)論本研究顯示RA患者存在明顯的骨質(zhì)疏松,并顯示骨代謝異常主要表現(xiàn)為β-CTX顯著高于對照組,提示破骨細(xì)胞活性增加不僅導(dǎo)致RA患者骨關(guān)節(jié)破壞而且導(dǎo)致繼發(fā)性骨質(zhì)疏松(OP)的發(fā)生;疾病越活動越容易出現(xiàn)OP,維生素D的缺乏在RA并發(fā)骨質(zhì)疏松中起到一定的作用。提示在RA治療中應(yīng)該盡早干預(yù)OP,積極治療RA同時補充維生素D有助于OP的防治。
[Abstract]:Objective to investigate the changes and clinical significance of bone metabolites in serum of patients with rheumatoid arthritis (RA). Methods 64 patients with RA and 30 healthy controls were selected as control group. The serum levels of BGP, 尾 -CTX, PINP, OHV Vit D3, ESRP, and anti-CCP antibodies were detected in patients with BGP, 尾 -CTX, PINPX and OHV Vit D3. The disease activity index (DAS 28) and bone mineral density (BMD) of lumbar vertebrae and femur were measured by DEXA. SPSS 20.0 statistical software was used to analyze the results. 緇撴灉 RA緇勎，

本文編號：1934478