【摘要】 目的分析强直性脊柱炎(AS)并发骨质疏松(OP)患者的骨密度及骨代谢指标水平的变化及其临床意义。方法选取2017年1月至2018年12月该院收治的65例AS合并OP患者为AS+OP组,70例单纯AS患者为AS组,并于同期选取40例健康志愿者为对照组。检测受试者骨密度(腰椎、股骨颈、股骨粗隆、Ward′s三角区),以及血清Ⅰ型胶原羧基端前肽(CICP)、Ⅰ型胶原羧基端交联肽(CTX-Ⅰ)、骨碱性磷酸酶(BALP)、甲状旁腺激素(PTH)、骨钙素(BGP)、尿脱氧胶原吡啶交联(D-Pyr)水平,并进行比较及相关性分析。结果 AS+OP组AS病程比AS组长,累及外周关节数、骶髂关节CT分级高于AS组,差异均有统计学意义(P<0.05)。与对照组比较,AS+OP组、AS组各检测部位骨密度及血清PTH、BGP水平均明显降低(P<0.05),且AS+OP组均明显低于AS组(P<0.05);血清CICP、CTX-Ⅰ、D-Pyr水平明显升高(P<0.05),且AS+OP组明显高于AS组(P<0.05)。Pearson相关分析结果显示,腰椎、股骨颈、股骨粗隆、Ward′s三角区骨密度与CICP、CTX-Ⅰ、D-Pyr水平呈负相关(P<0.05),与PTH、BGP水平呈正相关(P<0.05),与BALP无明显相关性(P>0.05)。结论 AS合并OP患者存在不同程度的骨密度降低及骨代谢异常,联合检测可辅助临床早期评估患者病情。更多还原

【Abstract】 Objective To explore the indicators of bone mineral density and bone metabolism in patients with ankylosing spondylitis(AS)complicated with osteoporosis(OP)and their clinical significances.Methods A total of 65 patients with AS complicated with OP in our hospital from January 2016 to December2018 were collected as the AS+OP group,70 patients with AS as the AS group,40 healthy volunteers at the same time as the control group.The bone mineral density(lumbar vertebrae,femoral neck,femur trochanter,Ward′s trigonum),type I collagen carboxy-terminal propeptide(CICP),type I collagen cross-linked carboxyterminal peptide(CTX-Ⅰ)and bone alkaline phosphatase(BALP),parathyroid hormone(PTH),osteocalcin(BGP),urinary deoxy-pyridinoline cross-linked collagen(D-Pyr)were detected and comparatively analyzed.Results The AS duration of the AS+OP group was longer than that of the AS group,and the number of peripheral joints involved and the CT grading of sacroiliac joints were higher than those of the AS group,with statistical significances(P<0.05).Compared with the control group,the bone mineral density and serum PTH and BGP levels of each detection site in the AS+OP and AS groups significantly decreased(P<0.05),and those in the AS+OP group were significantly lower than those in the AS group(P<0.05).The levels of CICP,CTX-Ⅰand D-PYR significantly increased(P<0.05),and those in the AS+OP group were significantly higher than those in the AS group(P<0.05).The results of Pearson correlation analysis showed that the bone mineral density of lumbar vertebrae,femoral neck,femur trochanter,Ward′s trigonum were negatively correlated with the levels of CICP,CTX-Ⅰand D-PYR(P<0.05),and positively correlated with the levels of PTH and BGP(P<0.05),but had no significant correlation with BALP(P>0.05).Conclusion The patients with AS complicated with OP had bone density decreasing and abnormal bone metabolism with different degrees.Combined detection can be used for early evaluating in clinic.更多还原