[1]杨群政,章先锋,陈英,等.类风湿关节炎与骨质疏松症的关系研究[J].中医正骨,2021,33(02):26-29.
 YANG Qunzheng,ZHANG Xianfeng,CHEN Ying,et al.A clinical study on the relationships between rheumatoid arthritis and osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):26-29.
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类风湿关节炎与骨质疏松症的关系研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年02期
页码:
26-29
栏目:
临床研究
出版日期:
2021-02-20

文章信息/Info

Title:
A clinical study on the relationships between rheumatoid arthritis and osteoporosis
作者:
杨群政章先锋陈英卢舒浩王守军
(杭州市富阳区中医院,浙江 杭州 311400)
Author(s):
YANG QunzhengZHANG XianfengCHEN YingLU ShuhaoWANG Shoujun
Fuyang Hospital of Traditional Chinese Medicine,Hangzhou 311400,Zhejiang,China
关键词:
关节炎类风湿 骨质疏松 体质学说 骨密度 碱性磷酸酶 胶原Ⅰ型
Keywords:
arthritisrheumatoid osteoporosis physical constitution theory bone density alkaline phosphatase collagen typeⅠ
摘要:
目的:探讨类风湿关节炎与骨质疏松症的关系。方法:2018年9月至2019年9月,招募类风湿关节炎患者121例(类风湿关节炎组)、健康体检者121例(健康体检组)。采用双能X线吸收法测定腰椎(L2~L4)骨密度和股骨颈骨密度,按照《中国人骨质疏松症诊断标准专家共识(第三稿·2014版)》中骨质疏松的诊断标准进行评定。采用免疫化学发光法测定血清骨碱性磷酸酶(bone alkaline phosphatase,BALP)、Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)、Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)含量。按照《中医基础理论》中9种常见体质判定标准判定类风湿关节炎患者的体质类型。结果:类风湿关节炎组的腰椎骨密度、股骨颈骨密度均低于健康体检组[(0.67±0.22)g·cm-2,(1.24±0.30)g·cm-2,t=-16.854,P=0.000;(0.58±0.18)g·cm-2,(0.95±0.27)g·cm-2,t=-12.542,P=0.000]; 血清BALP、PⅠNP含量均低于健康体检组[(17.22±3.50)μg·L-1,(24.56±4.85)μg·L-1,t=-13.499,P=0.000;(45.66±8.52)ng·mL-1,(58.56±10.30)ng·mL-1,t=-10.616,P=0.000]; 血清β-CTX含量高于健康体检组[(0.78±0.20)ng·mL-1,(0.38±0.12)ng·mL-1,t=18.865,P=0.000]。121例类风湿关节炎患者中,体质类型分布排在前3位的依次是阳虚质(35例,28.93%)、阴虚质(22例,18.18%)、气虚质(17例,14.05%); 骨密度评定结果,正常32例、骨量减少40例、骨质疏松49例; 其中49例骨质疏松患者的体质类型分布,排在前3位的依次是阳虚质(16例,32.65%)、阴虚质(8例,16.33%)、血瘀质(7例,14.29%)。结论:类风湿关节炎可能继发骨质疏松症,阳虚质、阴虚质的类风湿关节炎患者最容易继发骨质疏松症。
Abstract:
To explore the relationships between rheumatoid arthritis(RA)and osteoporosis(OP).Methods:One hundred and twenty-one RA patients(RA group)and 121 healthy volunteers(healthy group)were recruited from September 2018 to September 2019.The bone mineral density(BMD)of lumbar vertebrae from L2 to L4 and femoral neck were detected by using dual-energy X-ray absorptiometry(DEXA),and were evaluated according to the diagnostic criteria of osteoporosis which was extracted from Expert consensus on the diagnosis of osteoporosis in Chinese Population(Third Draft·2014 Edition).The serum contents of bone alkaline phosphatase(BALP),β-C-terminal telopeptide of typeⅠcollagen(β-CTX)and N-terminal propeptide of typeⅠprecollagen(PⅠNP)were measured by using chemiluminescence immunoassay(CLIA).The physical constitution(TCM)type of RA patients were determined in accordance with the evaluation standards of 9 common physical constitutions(TCM)which was extracted from Fundamentals of Chinese Medicine.Results:The BMD of lumbar vertebrae and femoral neck were lower in RA group compared to healthy group(0.67±0.22 vs 1.24±0.30 g/cm(2),t=-16.854,P=0.000; 0.58±0.18 vs 0.95±0.27 g/cm(2),t=-12.542,P=0.000).The serum contents of BALP and PⅠNP were lower and the serum content of β-CTX was higher in RA group compared to healthy group(17.22±3.50 vs 24.56±4.85 μg/L,t=-13.499,P=0.000; 45.66±8.52 vs 58.56±10.30 ng/mL,t=-10.616,P=0.000; 0.78±0.20 vs 0.38±0.12 ng/mL,t=18.865,P=0.000).In 121 RA patients,the top 3 physical constitution(TCM)types included yang-deficiency constitution(35 cases,28.93%),yin-deficiency constitution(22 cases,18.18%)and qi-deficiency constitution(17 cases,14.05%)in turn.The evaluation results of BMD showed that normal bone mass,osteopenia and OP were found in 32,40 and 49 patients respectively.In the 49 OP patients,the top 3 physical constitution(TCM)types included yang-deficiency constitution(16 cases,32.65%),yin-deficiency constitution(8 cases,16.33%)and blood-stasis constitution(7 cases,14.29%)in turn.Conclusion:RA may cause secondary osteoporosis,and the RA patients with yang-deficiency constitution and yin-deficiency constitution are most likely to suffer from secondary osteoporosis.

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备注/Memo

备注/Memo:
基金项目:杭州市富阳区科技计划项目(2018SK003)
通讯作者:杨群政 E-mail:yangqunzheng1@163.com
更新日期/Last Update: 2021-02-20