【摘要】：目的:探討江西地區(qū)類(lèi)風(fēng)濕關(guān)節(jié)炎(RA)患者骨密度(BMD)水平變化、骨代謝情況的臨床特征。方法:數(shù)據(jù)來(lái)源于國(guó)家風(fēng)濕病數(shù)據(jù)中心網(wǎng)絡(luò)注冊(cè)系統(tǒng)南昌大學(xué)二附屬分中心,以2015年4月至2017年2月就診于我院的RA患者為主。篩選出入組前同時(shí)進(jìn)行了左髖關(guān)節(jié)及腰椎BMD的測(cè)定、關(guān)節(jié)X線(xiàn)檢查、骨代謝指標(biāo)測(cè)定的RA患者。按骨密度測(cè)定結(jié)果分為骨質(zhì)疏松、低骨量、骨量正常三組,觀察三組在性別、年齡、發(fā)病年齡、病程、絕經(jīng)情況、身體質(zhì)量指數(shù)(BMI)、腫脹關(guān)節(jié)數(shù)(SJC)、壓痛關(guān)節(jié)數(shù)(TJC)、有無(wú)使用糖皮質(zhì)激素、血清鈣、血清磷、血沉、C反應(yīng)蛋白、DAS28、DAS44、SDAI、CDAI、X線(xiàn)改變、類(lèi)風(fēng)濕因子滴度、抗環(huán)胱氨酸肽(CCP)抗體滴度、骨鈣素、堿性磷酸酶、甲狀旁腺素、25-羥基維生素D等方面變化情況。結(jié)果:1、共81例患者符合標(biāo)準(zhǔn),男性16例(19.8%)、女性65例(80.2%)。骨質(zhì)疏松35例(43.2%)、低骨量25例(30.9%)、骨量正常21例(25.9%)。OP在腰椎發(fā)生率為39.5%,左髖關(guān)節(jié)為33.3%。2、三組在性別、年齡、發(fā)病年齡、絕經(jīng)情況、血清鈣、25-羥基維生素D差異有統(tǒng)計(jì)學(xué)意義(P0.05);在BMI、病程、腫脹關(guān)節(jié)數(shù)、壓痛關(guān)節(jié)數(shù)、有無(wú)使用糖皮質(zhì)激素、ESR、CRP、血P、RF滴度、抗CCP抗體滴度、DAS28、DAS44、SDAI、CDAI、骨鈣素、堿性磷酸酶、甲狀旁腺素等方面差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3、三組局部骨損害發(fā)生率逐漸減低,以O(shè)P組最高,但無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論:RA合并OP與性別、發(fā)病年齡、是否絕經(jīng)、25-羥基維生素D缺乏相關(guān)。對(duì)RA患者,尤其是高齡或絕經(jīng)女性患者應(yīng)常規(guī)進(jìn)行骨密度的篩查,早期即補(bǔ)充維生素D3和鈣劑。
[Abstract]:Objective: to investigate the changes of bone mineral density (BMD) and bone metabolism in patients with rheumatoid arthritis (RA) in Jiangxi province. Methods: the data were obtained from the second affiliated sub-center of Nanchang University, the network registration system of National Rheumatological data Center. The main data were RA patients in our hospital from April 2015 to February 2017. BMD of left hip and lumbar vertebrae, X-ray examination of joint and bone metabolism were measured in RA patients before screening. According to the results of bone mineral density measurement, the patients were divided into three groups: osteoporosis, low bone mass and normal bone mass. The sex, age, onset age, course of disease, menopause were observed in the three groups. Body mass index (BMI),) swelling joint number (SJC), tenderness joint number (TJC), whether use glucocorticoid, serum calcium, serum phosphorus, erythrocyte sedimentation rate, C-reactive protein, DAS28,DAS44,SDAI,CDAI,X line change, rheumatoid factor titer, anti-cysteine peptide (CCP) antibody titer, osteocalcin, Alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D and so on. Results: 1. There were 81 patients, 16 males (19.8%) and 65 females (80.2%). There were 35 cases of osteoporosis (43.2%), 25 cases of low bone mass (30.9%), 21 cases of normal bone mass (25.9%). OP), 39.5% of lumbar vertebrae and 33.33.2% of left hip joint. There were significant differences in sex, age, age of onset, menopause, serum calcium and 25-hydroxyl vitamin D in the three groups (P0.05); The number of swollen joints, the number of tenderness joints, whether glucocorticoid was used, the titer of ESR,CRP, blood, the titer of anti CCP antibody, DAS28,DAS44,SDAI,CDAI, osteocalcin, alkaline phosphatase, parathyroid hormone and so on were not significantly different (P0.05). OP group was the highest, but there was no statistical difference. Conclusion: RA combined with OP is associated with sex, age of onset, menopause and 25-hydroxyvitamin D deficiency. BMD screening should be performed regularly in RA patients, especially in elderly or menopausal women, and vitamin D 3 and calcium should be supplemented at the early stage.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R593.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 麻璨琛;徐勝前;龔勛;吳穎;齊姍;劉文;肖會(huì);徐建華;;類(lèi)風(fēng)濕關(guān)節(jié)炎患者中糖皮質(zhì)激素誘發(fā)骨質(zhì)疏松的臨床研究[J];中華風(fēng)濕病學(xué)雜志;2016年12期

2 ;《凱利風(fēng)濕病學(xué)》第9版精裝中譯版出版發(fā)行[J];中華醫(yī)學(xué)雜志;2016年03期

3 鄒伏英;王友蓮;霍亞南;;類(lèi)風(fēng)濕關(guān)節(jié)炎患者的骨密度和疾病活動(dòng)相關(guān)性研究[J];江西醫(yī)藥;2013年01期

4 鄧娟;裴必偉;徐勝前;劉童;陳晨;徐建華;;類(lèi)風(fēng)濕關(guān)節(jié)炎患者全身骨質(zhì)疏松和局部骨侵蝕的關(guān)系研究[J];中華風(fēng)濕病學(xué)雜志;2012年10期

5 王明霞;黃建林;羅敏琪;巫世瑤;朱尚玲;彭蔚湘;古潔若;;類(lèi)風(fēng)濕關(guān)節(jié)炎患者骨質(zhì)疏松及其相關(guān)因素的初步調(diào)查[J];中華骨質(zhì)疏松和骨礦鹽疾病雜志;2011年04期

6 趙熠;蔡育;王貽寧;;破骨細(xì)胞前體細(xì)胞的研究進(jìn)展[J];國(guó)際口腔醫(yī)學(xué)雜志;2011年06期

7 王彥焱;賈娜;魏麗;;類(lèi)風(fēng)濕關(guān)節(jié)炎患者并發(fā)骨質(zhì)疏松的臨床研究[J];中國(guó)骨質(zhì)疏松雜志;2010年11期

8 王彥焱;趙春梅;魏麗;古麗仙.艾爾肯;賈娜;;藥物對(duì)類(lèi)風(fēng)濕關(guān)節(jié)炎患者骨密度的影響[J];新疆醫(yī)科大學(xué)學(xué)報(bào);2010年02期

9 臧謀圣;王玉;徐勝前;荊春艷;;瘦素和可溶性瘦素受體在類(lèi)風(fēng)濕關(guān)節(jié)炎中的變化及其與骨質(zhì)疏松的關(guān)系研究[J];中華風(fēng)濕病學(xué)雜志;2010年01期

10 臧謀圣;張林杰;徐勝前;徐建華;李群;;絕經(jīng)后女性類(lèi)風(fēng)濕關(guān)節(jié)炎患者骨密度的臨床研究[J];臨床軍醫(yī)雜志;2008年06期

，

本文編號(hào)：2294127