摘要
目的 研究强直性脊柱炎 (AS)患者骨质疏松的发生及其相关因素 ,分析骨质疏松与骨代谢指标的关系。方法 对 3 0例AS患者用双能X线吸收法 (DEXA)测定腰椎和股骨颈骨密度(BMD) ,用酶联免疫法测定血清骨钙素 (BGP)、骨碱性磷酸酶 (BAP)及尿脱氧吡啶胶原交联(D Pyr)。结果 AS早期腰椎及股骨颈BMD均较对照组低 ,而晚期椎体周围软组织骨化使腰椎BMD增加 ,但股骨颈BMD仍低于对照组。 3 0例AS患者中 ,骨质疏松 6例 ,骨量减少 10例。AS的股骨颈BMD与病程、血沉 (ESR)、C 反应蛋白 (CRP)和X线分期呈负相关 ,绝经前女性BMD的变化不如男性明显 ,HLA B2 7阳性与阴性患者BMD无明显差异。AS骨质疏松组 ,骨形成的指标(BGP、BAP)与对照组比较 ,差异无显著性 ,骨吸收的指标 (D Pyr)明显增高。 结论 AS继发全身性骨质疏松不少见 ,其发生与病程、疾病活动性和疾病严重程度相关 。
Objective To study the frequency of osteoporosis,risk factors,relationship between bone turnover makers and bone mineral density (BMD) in patients with ankylosing spondylitis (AS).Methods BMD in the spine and femoral neck was measured with dual energy x ray absorptiometry(DEXA) in 30 AS patients.Enzyme linked immunoassay was used to measure serum bone Gla containing protein(BGP),bone specific alkaline phosphatase(BAP) and urine deoxypyridinoline crosslinks(D Pyr).Results The patients lost already the bone mass in early stage of AS, and had lower volume of BMD in both hip and spine than healthy controls.But in the late stage,the BMD of the spines was higher than that of the control group due to the calcification of the surrounding tissues of the spine,even the BMD of femoral neck was still lower than that of healthy objects.Osteoporosis was observed in 6 patients,osteopenia in 10.Osteoporosis in AS was related to disease duration,ESR,CRP,and X ray grades.The reduction of BMD in premenopausal women with early AS was slighter than that in men.The BMD had no significant differences between HLA B27(+) patients and HLA B27( ) patients.BGP and BAP,which reflect bone formation,had no differences between AS patients and controls.D Pyr that reflects bone resorption had significantly increased compared with controls.Conclusion Osteoporosis in AS is common and may be related to disease duration,activity and severity.A significant increase of bone resorption is observed in AS with osteoporosis.
出处
《临床内科杂志》
CAS
北大核心
2002年第6期456-458,共3页
Journal of Clinical Internal Medicine
关键词
骨密度
骨代谢
强直性脊柱炎
骨质疏松
Ankylosing spondylitis
Osteoporosis
Bone mineral density
Bone metabolism
