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[1]楊群政,章先鋒,陳英,等.類風(fēng)濕關(guān)節(jié)炎與骨質(zhì)疏松癥的關(guān)系研究[J].中醫(yī)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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類風(fēng)濕關(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33卷
期數(shù):
2021年02期
頁(yè)碼:
26-29
欄目:
臨床研究
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:
楊群政; 章先鋒; 陳英; 盧舒浩; 王守軍
(杭州市富陽(yáng)區(qū)中醫(yī)院,浙江 杭州 311400)
Author(s):
YANG Qunzheng; ZHANG Xianfeng; CHEN Ying; LU Shuhao; WANG Shoujun
Fuyang Hospital of Traditional Chinese Medicine,Hangzhou 311400,Zhejiang,China
關(guān)鍵詞:
關(guān)節(jié)炎; 類風(fēng)濕;  骨質(zhì)疏松;  體質(zhì)學(xué)說(shuō);  骨密度;  堿性磷酸酶;  膠原Ⅰ型
Keywords:
arthritis; rheumatoid;  osteoporosis;  physical constitution theory;  bone density;  alkaline phosphatase;  collagen typeⅠ
摘要:
目的:探討類風(fēng)濕關(guān)節(jié)炎與骨質(zhì)疏松癥的關(guān)系。方法:2018年9月至2019年9月,招募類風(fēng)濕關(guān)節(jié)炎患者121例(類風(fēng)濕關(guān)節(jié)炎組)、健康體檢者121例(健康體檢組)。采用雙能X線吸收法測(cè)定腰椎(L2～L4)骨密度和股骨頸骨密度,按照《中國(guó)人骨質(zhì)疏松癥診斷標(biāo)準(zhǔn)專家共識(shí)(第三稿·2014版)》中骨質(zhì)疏松的診斷標(biāo)準(zhǔn)進(jìn)行評(píng)定。采用免疫化學(xué)發(fā)光法測(cè)定血清骨堿性磷酸酶(bone alkaline phosphatase,BALP)、Ⅰ型膠原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)、Ⅰ型前膠原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)含量。按照《中醫(yī)基礎(chǔ)理論》中9種常見體質(zhì)判定標(biāo)準(zhǔn)判定類風(fēng)濕關(guān)節(jié)炎患者的體質(zhì)類型。結(jié)果:類風(fēng)濕關(guān)節(jié)炎組的腰椎骨密度、股骨頸骨密度均低于健康體檢組[(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含量均低于健康體檢組[(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含量高于健康體檢組[(0.78±0.20)ng·mL-1,(0.38±0.12)ng·mL-1,t=18.865,P=0.000]。121例類風(fēng)濕關(guān)節(jié)炎患者中,體質(zhì)類型分布排在前3位的依次是陽(yáng)虛質(zhì)(35例,28.93%)、陰虛質(zhì)(22例,18.18%)、氣虛質(zhì)(17例,14.05%); 骨密度評(píng)定結(jié)果,正常32例、骨量減少40例、骨質(zhì)疏松49例; 其中49例骨質(zhì)疏松患者的體質(zhì)類型分布,排在前3位的依次是陽(yáng)虛質(zhì)(16例,32.65%)、陰虛質(zhì)(8例,16.33%)、血瘀質(zhì)(7例,14.29%)。結(jié)論:類風(fēng)濕關(guān)節(jié)炎可能繼發(fā)骨質(zhì)疏松癥,陽(yáng)虛質(zhì)、陰虛質(zhì)的類風(fēng)濕關(guān)節(jié)炎患者最容易繼發(fā)骨質(zhì)疏松癥。
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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備注/Memo

備注/Memo:
基金項(xiàng)目:杭州市富陽(yáng)區(qū)科技計(jì)劃項(xiàng)目(2018SK003)
通訊作者:楊群政 E-mail:[email protected]
更新日期/Last Update: 2021-02-20