摘要
目的探讨女性类风湿关节炎（RA）患者外周血核因子-κB受体活化因子配体（RANKL）和护骨素（OPG）水平的变化及其与女性RA骨质疏松的相关性。方法采用ELISA法测定55例女性RA患者和53例正常女性外周血中RANKL和OPG水平，采用双能X线骨密度吸收仪测定骨密度。结果（1）和正常女性相比，女性RA患者RANKL水平明显升高，OPG水平明显降低（P〈0．001）。（2）女性RA组中骨质疏松发生率38．2％（21／55）明显高于正常女性组[11．3％（6／53）]；这种改变不但体现在已绝经的女性RA患者和已绝经的正常女性，同样体现在未绝经的女性RA患者和未绝经的正常女性（Neck部位骨密度除外）。（3）女性RA患者OPG水平与骨密度呈正直线相关；RANKL与之相反（P〈0．05）。（4）Logistic分析显示：OPG／RANKL比值为女性RA患者中骨质疏松发生的保护因素（OR=0．027，P=0．014，95％CI：0．001～0．478）。结论女性RA患者外周血OPG水平、RANKL水平的变化与骨代谢状态的变化密切相关；外周血OPG／RANKL比为女性RA患者中骨质疏松发生的保护因素。
Objectives To determine the levels of OPG and RANKL in peripheral blood of female RA patients and investigate the relationship between the level of OPG/RANKL and osteoporosis in female RA patients. Methods A total of 55 patients with female RA and 53 normal female controls were involved. The levels of OPG and RANKL were detected by ELISA. Bone mineral density （ BMD ） of non- dominant forearm, lumbar vertebrae（ L1-4 ） and hip were measured by dual energy X-ray absorptiometry. Results （ 1 ） Compared with normal female controls, the level of OPG in RA patients decreased significantly while the level of RANKL increased obviously （P 〈 0. 0001 ）. （2）The incidence of osteoporosis in female RA patients （ 38.2%, 21/55 ） was higher than that in normal female controls （ 11.3 % ,6/53 ）. BMD in postmenopausal or premenopausal femal RA patients were significant lower than that in premenopausal or premenopausal （except BMD of neck of hip） normal female controls（ P 〈 0.01 ）. Compared with premenopausal RA patients, BMD of all detected site in postmenopausal female RA patients decreased significantly（ P 〈 0.05 ）. （3）There were positive line correlations between the level of OPG and BMD in female RA （P 〈 0. 05-0. 0001 ）, while the level of RANKL correlated with BMD which presented as negative line correlations （P 〈 0.05-0. 0001 ）. （4）Analysis of Logistic Regression showed the level of OPG/RANKL was a protective factor in occurrence of osteoporosis in female RA patients （ OR = 0. 027, P = 0. 014,95% Cl ： 0. 001-0. 478 ） . Conclusion There was a close correlation between the level of OPG and RANKL in peripheral blood of female RA and its bone metabolism status. The level of OPG/RANKL was a protective factor in occurrence of osteoporosis in female RA patients.
出处
《临床内科杂志》
CAS
2010年第7期449-451,共3页
Journal of Clinical Internal Medicine
