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[1]王彭禾,汪小健,吳叢姿,等.血友病性關(guān)節(jié)炎與骨質(zhì)疏松癥的關(guān)系研究[J].中醫(yī)正骨,2022,34(02):31-35+53.
　.The First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 00,Zhejiang,et al.WANG Penghe1,WANG Xiaojian1,WU Congzi1,SHI Zhenyu1,JIN Hongting1,WANG Pinger1,TONG Peijian2[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):31-35+53.
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血友病性關(guān)節(jié)炎與骨質(zhì)疏松癥的關(guān)系研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年02期
頁碼:
31-35+53
欄目:
臨床研究
出版日期:
2022-02-20

文章信息/Info

Title:
WANG Penghe1,WANG Xiaojian1,WU Congzi1,SHI Zhenyu1,JIN Hongting1,WANG Pinger1,TONG Peijian2
作者:
王彭禾1; 汪小健1; 吳叢姿1; 施振宇1; 金紅婷1; 王萍兒1; 童培建2
1.浙江中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,浙江 杭州 310053; 2.浙江省中醫(yī)院,浙江 杭州 310006
Author(s):
1.The First Clinical Medical College of Zhejiang Chinese Medical University; Hangzhou 310053; Zhejiang; China
2.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
關(guān)節(jié)炎;  血友病A;  血友病B;  骨密度;  骨質(zhì)疏松
Keywords:
arthritis;  hemophilia A;  hemophilia B;  bone density;  osteoporosis
摘要:
目的:探討血友病性關(guān)節(jié)炎與骨質(zhì)疏松癥的關(guān)系。方法:回顧性分析2019年12月至2020年12月收治的40例男性血友病性關(guān)節(jié)炎患者(血友病性關(guān)節(jié)炎組)和60例門診健康體檢男性(健康體檢組)的病例資料。比較2組受試者的血清骨代謝指標(biāo)及血液生化指標(biāo),前者包括25-羥基維生素D、甲狀旁腺激素、總Ⅰ型膠原氨基端前肽(total N-terminal propeptide of typeⅠcollagen,TPⅠNP)、骨鈣素、降鈣素、Ⅰ型膠原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX),后者包括鈣、磷、堿性磷酸酶(alkaline phosphatase,ALP)、超敏C反應(yīng)蛋白(supersensitive C-reaction protein,SCRP)、紅細胞沉降率(erythrocyte sedimentation rate,ESR); 比較2組受試者的左側(cè)股骨頸和腰椎(L1～L4)骨密度T值。根據(jù)血友病的病情程度將40例血友病性關(guān)節(jié)炎患者分為輕度、中度、重度3組,比較3組患者的左側(cè)股骨頸和腰椎(L1～L4)骨密度T值。結(jié)果:①血清骨代謝指標(biāo)。血友病性關(guān)節(jié)炎組的血清TPⅠNP、骨鈣素、β-CTX含量均高于健康體檢組[(76.8±31.1)ng·mL-1,(56.9±16.4)ng·mL-1,t=-3.391,P=0.001;(19.8±6.1)ng·mL-1,(16.0±4.5)ng·mL-1,t=-3.944,P=0.001;(780.6±336.1)pg·mL-1,(528.9±174.4)pg·mL-1,t=-4.489,P=0.001]。2組受試者血清25-羥基維生素D、甲狀旁腺激素、降鈣素含量比較,組間差異均無統(tǒng)計學(xué)意義[(20.7±10.3)ng·mL-1,(19.2±8.4)ng·mL-1,t=0.814,P=0.418;(39.1±18.0)pg·mL-1,(40.2±12.3)pg·mL-1,t=-1.175,P=0.240;(2.5±2.8)pg·mL-1,(2.9±2.4)pg·mL-1,t=-1.468,P=0.142]。②血液生化指標(biāo)。血友病性關(guān)節(jié)炎組的血清鈣含量低于健康體檢組[(2.28±0.12)mmol·L-1,(2.33±0.11)mmol·L-1,t=-2.089,P=0.039],血清SCRP含量高于健康體檢組[(7.99±12.85)mg·L-1,(3.42±4.51)mg·L-1,t=-2.232,P=0.026]。2組受試者血清磷含量、血清ALP含量、ESR比較,組間差異均無統(tǒng)計學(xué)意義[(1.21±0.19)mmol·L-1,(1.23±0.22)mmol·L-1,t=-0.631,P=0.529;(74.78±12.52)單位·L-1,(76.40±16.30)單位·L-1,t=-0.493,P=0.622;(5.13±6.77)mm·h-1,(5.47±13.87)mm·h-1,t=-1.660,P=0.097]。③骨密度T值。血友病性關(guān)節(jié)炎組的股骨頸骨密度T值低于健康體檢組(-1.18±1.17,0.48±1.21,t=-5.814,P=0.001),2組受試者腰椎骨密度T值比較,差異無統(tǒng)計學(xué)意義(0.04±1.25,0.17±0.93,t=-1.577,P=0.115)。40例血友病性關(guān)節(jié)炎患者按照血友病的病情程度分為3組,其中輕度組10例、中度組16例、重度組14例。3組患者股骨頸骨密度T值比較,差異無統(tǒng)計學(xué)意義(-1.09±1.22,-0.87±1.31,-1.78±0.85,F=2.424,P=0.103)。3組患者腰椎骨密度T值總體比較,差異有統(tǒng)計學(xué)意義(0.01±1.23,0.41±1.44,-0.73±0.81,F=3.277,P=0.049); 進一步兩兩比較發(fā)現(xiàn),中度組的腰椎骨密度T值大于重度組(P=0.015),輕度組的腰椎骨密度T值與中度組和重度組比較差異無統(tǒng)計學(xué)意義(P=0.700,P=0.138)。結(jié)論:血友病性關(guān)節(jié)炎可能繼發(fā)骨質(zhì)疏松癥,但血友病病情程度與骨質(zhì)疏松程度無明確關(guān)系。
Abstract:
Objective:To explore the relationship between hemophilic arthritis(HA)and osteoporosis(OP).Methods:The medical records of 40 HA male patients(HA group)and 60 healthy male volunteers(healthy group)recruited from December 2019 to December 2020 were analyzed retrospectively.The serum markers of bone metabolism including 25-hydroxy vitamin D(25(OH)D),parathyroid hormone(PTH),total N-terminal propeptide of typeⅠcollagen(TPⅠNP),osteocalcin(OCN),calcitonin,β-C-terminal telopeptide of typeⅠcollagen(β-CTX)and the blood biochemical indexes including calcium(Ca),phosphorus(P),alkaline phosphatase(ALP),supersensitive C-reaction protein(SCRP)and erythrocyte sedimentation rate(ESR)were compared between the 2 groups.The T values of bone mineral density(BMD)of left femoral neck(FN)and lumbar vertebra(LV)from L1 to L4 were compared between the 2 groups.According to the degree of HA,the 40 patients were divided into mild group(10 cases),moderate group(16 cases)and severe group(14 cases),and the T values of BMD of left FN and LV from L1 to L4 were compared between the 2 groups.Results:①The serum levels of TPⅠNP,OCN and β-CTX were higher in HA group compared to healthy group(76.8±31.1 vs 56.9±16.4 ng/mL,t=-3.391,P=0.001; 19.8±6.1 vs 16.0±4.5 ng/mL,t=-3.944,P=0.001; 780.6±336.1 vs 528.9±174.4 pg/mL,t=-4.489,P=0.001).There was no statistical difference in the serum levels of 25(OH)D,PTH and calcitonin between the 2 groups(20.7±10.3 vs 19.2±8.4 ng/mL,t=0.814,P=0.418; 39.1±18.0 vs 40.2±12.3 pg/mL,t=-1.175,P=0.240; 2.5±2.8 vs 2.9±2.4 pg/mL,t=-1.468,P=0.142).②The serum level of Ca was lower and the serum level of SCRP was higher in HA group compared to healthy group(2.28±0.12 vs 2.33±0.11 mmol/L,t=-2.089,P=0.039; 7.99±12.85 vs 3.42±4.51 mg/L,t=-2.232,P=0.026).There was no statistical difference in the ESR and the serum levels of P and ALP between the 2 groups(5.13±6.77 vs 5.47±13.87 mm/h,t=-1.660,P=0.097; 1.21±0.19 vs 1.23±0.22 mmol/L,t=-0.631,P=0.529; 74.78±12.52 vs 76.40±16.30 unit/L,t=-0.493,P=0.622).③The T value of BMD of FN was smaller in HA group compared to healthy group(-1.18±1.17 vs 0.48±1.21,t=-5.814,P=0.001).There was no statistical difference in the T value of BMD of LV from L1 to L4 between the 2 groups(0.04±1.25 vs 0.17±0.93,t=-1.577,P=0.115).There was no statistical difference in the T value of BMD of FN among mild group,moderate group and severe group(-1.09±1.22,-0.87±1.31,-1.78±0.85,F=2.424,P=0.103).There was statistical difference in the T value of BMD of LV from L1 to L4 among mild group,moderate group and severe group in general(0.01±1.23,0.41±1.44,-0.73±0.81,F=3.277,P=0.049).Further pairwise comparison showed that the T value of BMD of LV from L1 to L4 was larger in mild group compared to severe group,and there was no statistical difference between mild group and moderate group as well as between mild group and severe group(P=0.700,P=0.138).Conclusion:HA may cause secondary OP,but there is no clear relationship between the degree of HA and the degree of OP.

參考文獻/References:

[1] PETERS R,HARRIS T.Advances and innovations in haemophilia treatment[J].Nat Rev Drug Discov,2018,17(7):493-508.
[2] IORIO A,STONEBRAKER J S,CHAMBOST H,et al.Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries[J].Ann Intern Med,2019,171(8):540-546.
[3] CAVIGLIA H,LANDRO M E,GALATRO G,et al.Epidemiology of fractures in patients with haemophilia[J].Injury,2015,46(10):1885-1890.
[4] GHOSH K,SHETTY S.Bone health in persons with haemophilia:a review[J].Eur J Haematol,2012,89(2):95-102.
[5] EKINCI O,DEMIRCIOGLU S,DOGAN A,et al.Decreased bone mineral density and associated factors in severe haemophilia A patients:A case-control study[J].Haemophilia,2019,25(5):e315-e321.
[6] LEWIECKI E M,BINKLEY N,MORGAN S L,et al.Best practices for dual-energy X-ray absorptiometry measurement and reporting:International Society for Clinical Densitometry guidance[J].J Clin Densitom,2016,19(2):127-140.
[7] GALLACHER S J,DEIGHAN C,WALLACE A M,et al.Association of severe haemophilia A with osteoporosis:a den-sitometric and biochemical study[J].Q J Med,1994,87(3):181-186.
[8] KATSAROU O,TERPOS E,CHATZISMALIS P,et al.Increased bone resorption is implicated in the pathogenesis of bone loss in hemophiliacs:correlations with hemophilic arthropathy and HIV infection[J].Ann Hematol,2010,89(1):67-74.
[9] SAHIN S,SADRI S,BASLAR Z,et al.Osteoporosis in patients with hemophilia:single-center results from a middle-income country[J/OL].Clin Appl Thromb Hemost,2019,25[2021-07-04].https://pubmed.ncbi.nlm.nih.gov/31282181/.
[10] DAGLI M,KUTLUCAN A,ABUSOGLU S,et al.Evaluation of bone mineral density(BMD)and indicators of bone turnover in patients with hemophilia[J].Bosn J Basic Med Sci,2018,18(2):206-210.
[11] LINARI S,MONTORZI G,BARTOLOZZI D,et al.Hypovi-taminosis D and osteopenia/osteoporosis in a haemophilia po-pulation:a study in HCV/HIV or HCV infected patients[J].Haemophilia,2013,19(1):126-133.
[12] LEE A,BOYD S K,KLINE G,et al.Premature changes in trabecular and cortical microarchitecture result in decreased bone strength in hemophilia[J].Blood,2015,125(13):2160-2163.
[13] PAGEL C N,SONG S J,LOH L H,et al.Thrombin-stimulated growth factor and cytokine expression in osteoblasts is mediated by protease-activated receptor-1 and pro-stanoids[J].Bone,2009,44(5):813-821.
[14] STRANDE J L,PHILLIPS S A.Thrombin increases inflammatory cytokine and angiogenic growth factor secretion in human adipose cells in vitro[J].J Inflamm(Lond),2009,6:4.
[15] TARDY-PONCET B,PLAY B,MONTMARTIN A,et al.PHILEOS(haemoPHILia and ostEoporOSis)study:protocol of a multicentre prospective case-control study[J/OL].BMJ Open,2021,11(1)[2021-07-04].https://pubmed.ncbi.nlm.nih.gov/33441362/.
[16] ANAGNOSTIS P,VAKALOPOULOU S,CHRISTOULAS D,et al.The role of sclerostin/dickkopf-1 and receptor activator of nuclear factor kB ligand/osteoprotegerinsignalling pathways in the development of osteoporosis in patients with haemophilia A and B:A cross-sectional study[J].Haemophilia,2018,24(2):316-322.
[17] RECHT M,LIEL M S,TURNER R T,et al.The bone di-sease associated with factor VIII deficiency in mice is secondary to increased bone resorption[J].Haemophilia,2013,19(6):908-912.
[18] ALIOGLU B,SELVER B,OZSOY H,et al.Evaluation of bone mineral density in Turkish children with severe haemophilia A:Ankara hospital experience[J].Haemophilia,2012,18(1):69-74.
[19] IORIO A,FABBRICIANI G,MARCUCCI M,et al.Bone mineral density in haemophilia patients.A meta-analysis[J].Thromb Haemost,2010,103(3):596-603.
[20] 桂先革,蔣增輝,陳標(biāo),等.骨鈣素和Ⅰ型前膠原N端前肽對骨質(zhì)疏松性椎體壓縮性骨折患者術(shù)后再骨折的預(yù)測價值[J].中華老年病研究電子雜志,2020,7(1):22-26.
[21] 粟麟,陳文輝,李雙蕾,等.2型糖尿病性骨質(zhì)疏松發(fā)病機制研究進展[J].實用中醫(yī)藥雜志,2013,29(6):499-501.
[22] 楊永紅,林明春,夏鳳瓊,等.骨標(biāo)志物OC、CTX-1、BAP、tP1NP的檢測在骨質(zhì)疏松癥中的臨床應(yīng)用[J].中外醫(yī)學(xué)研究,2015,13(27):162-164.
[23] HU T,YANG Q,XU J,et al.Role of β-isomerized C-terminal telopeptides(β-CTx)and total procollagen type 1 amino-terminal propeptide(tP1NP)as osteosarcoma biomarkers[J].Int J Clin Exp Med,2015,8(1):890-896.
[24] RODRIGUEZ-MERCHAN E C,VALENTINO L A.Increased bone resorption in hemophilia[J].Blood Rev,2019,33:6-10.
[25] PARHAMPOUR B,TORKAMAN G,HOORFAR H,et al.Effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in severe haemophilia A patients with osteoporosis:a randomized controlled trial[J].Clin Rehabil,2014,28(5):440-450.

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備注/Memo

備注/Memo:
基金項目:國家自然科學(xué)基金項目(81873324)
通訊作者:童培建 E-mail:[email protected]
更新日期/Last Update: 2022-02-20