摘要
目的对炎症性肠病（IBD）患者的骨密度状况进行评估，探讨其下降的危险因素。方法通过对IBD患者血液学指标、身高、体重及腰椎骨密度进行测量，并与健康志愿者比较，分析IBD患者骨质疏松的危险因素。结果共收集克罗恩病（CD）77例，溃疡性结肠炎（UC）43例，37例健康志愿者作为对照组。CD组、UC组及对照组的腰椎骨质的T值分别为-1．72±1．20、-1．26±1．12和-0．62±0．87，CD组的T值低于UC组（P=0．045）和对照组（P=0．000），UC组T值低于对照组（P=0．014）。CD组、UC组及对照组的腰椎骨质疏松的发生率分别为23．3％、14．0％和0；CD组的腰椎骨质疏松发生率高于对照组，差异有统计学意义（P=0．003）；UC组的腰椎骨质疏松发生率有高于对照组的趋势，但差异无统计学意义（P=0．053）。多元回归分析显示，低体重（BMI≤18．4 kg／m^2）是CD（OR=11．25，95％ CI 3．198～39．580，P=0．000）和UC（OR=14．50，95％CI 1．058～88．200，19=0．045）患者骨质疏松的危险因素。年龄、病程、病变部位、CD活动指数（CDAI）、服用糖皮质激素、服用免疫抑制剂、血清25-羟基维生素D浓度等因素与骨质疏松的发生无相关性。结论骨密度下降的发生在IBD患者中较为普遍，低体重是IBD患者骨质丢失的危险因素。
Objective To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease（IBD） and to identify its risk factors. Methods A cross-sectional survey was carried out in IBD patients. Anthropometric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects. Results Seventy-seven Crohn＇s disease （CD） and 43 ulcerative colitis（UC） patients were enrolled, and 37 healthy volunteers were recruited as healthy controls（HC）. The T value of CD patients, UC patients and HC was -1.72±1.20, - 1.26 ± 1.12 and -0.62 ±0.87 respectively and the T value of CD patients was significantly lower than that of HC （P = 0. 000）. The prevelance of osteoporosis in CD, UC and HC was 23.3% , 14. 0% and 0 respectively. The prevelance of osteoporosis in CD was higher than that in HC （P = 0. 003）. Logistic regression analysis indicated that low BMI （BMI ≤ 18.4 kg/m^2） was an independent risk factor for osteoporosis both in CD （ OR = 11.25,95% CI 3. 198 - 39. 580, P = 0. 000 ） and in UC （ OR = 14. 50,95% CI 1. 058 - 88. 200, P = 0. 045 ） patients. Age, disease duration, clinical activity active index （CDAI）, oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoporosis in IBD patients. Conclusions Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2009年第10期833-836,共4页
Chinese Journal of Internal Medicine
