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目的探讨骨代谢生化指标的检测在糖皮质激素诱导类风湿性关节炎骨质疏松症(osteoporosis,OP)中的作用。方法选择2013年5月-2014年5月在新疆医科大学第一附属医院风湿免疫科住院的55例类风湿性关节炎(rheumatoid arthritis,RA)患者,按入院前是否已经接受糖皮质激素治疗分为治疗组(已接受激素治疗)23例和非治疗组(未接受激素治疗)32例,所有患者均进行骨密度测定及血清25羟维生素D(25OHD)、骨钙素、血钙、血磷和血碱性磷酸酶的检测,并进行比较。结果治疗组骨钙素显著低于非治疗组患者,差异有统计学意义(P<0.01),而两组患者骨密度、血清25OHD、血钙、血磷和血碱性磷酸酶指标差异均无统计学意义(P>0.05)。结论骨代谢生化指标的降低可以较早提示骨代谢的变化,其改变早于骨密度,可以敏感地反映短期内的骨代谢情况,稳定性好,有利于RA患者治疗同时监测糖皮质激素治疗后的骨代谢紊乱情况,对RA患者的早期预防和治疗骨质疏松有指导意义。
Abstract：Objective To explore the role of bone metabolism in glucocorticoid-induced osteoporosis in rheumatoid arthritis. Methods 55 cases of rheumatoid arthritis( rheumatoid arthritis,RA) patients in the Division of Rheumatology of the First Affiliated Hospital of Xinjiang Medical University from May 2013 to May 2014 were selected as the subjects. The patients were divided into 23 cases of treated group and 32 cases of untreated group according to whether they received treatment of glucocorticoid therapy or not before hospitalization. All patients underwent a bone mineral density,serum 25-hydroxyvitamin D(25OHD),osteocalcin,calcium,phosphorus and blood alkaline phosphatase detection,and the results were compared. Results The osteocalcin in the treatment group was significantly lower than that in untreated group and the difference was statistically significant( P < 0. 01). Bone mineral density,serum 25 OHD,calcium,phosphorus and alkaline blood phosphatase indicators were not statistically significant( P > 0. 05). Conclusion The decrease of bone metabolism may indicate changes in bone metabolism earlier than bone density,thus sensitively reflecting the bone condition in the short term. The bone metabolism markers may help monitor the treatment on the RA patient and predict the bone metabolism disorder after the treatment.Therefore,the observation of bone metabolism markers is useful in early prevention and treatment of osteoporosis.
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基本信息:
中图分类号:R580;R593.22
引用信息:
[1]葛金莲,买买提伊明·吐尔逊,罗德梅.骨代谢生化指标在糖皮质激素诱导类风湿性关节炎骨质疏松症中的意义[J].新疆医科大学学报,2015,38(08):1011-1013+1017.
基金信息:
新疆医学动物模型研究重点实验室开放课题(XJDX1103-2012-07)
2015-08-15
2015-08-15