绝经后膝骨关节炎发生发展与骨密度的相关性研究

The Association between Occurrence and Development of Postmenopausal Knee Osteoarthritis and Bone Mineral Density

目的:通过分析和比较绝经后正常人群以及不同程度膝骨关节炎(KOA)患者骨密度及骨代谢指标,探讨绝经后女性KOA对骨密度的影响。方法:依据Lequesne指数测试得分情况,将166名绝经后妇女分成正常、轻、中、重组,并测定双光能X线骨密度、骨代谢指标(骨特异性碱性磷酸酶BAP、Ⅰ型胶原交联C末端肽CTX-1)以及拍摄膝关节站立位X线片,观察不同分组中各项指标的变化。结果:绝经后KOA患者与正常人群比较,骨密度减低及患骨质疏松症人数之和(即T值≤-1人数)占各组总人数的比存在差异(P<0.05)。BAP值在不同程度KOA患者中存在差异(P<0.05),CTX-1值在正常、轻、中组中存在差异(P<0.05)。结论:早期KOA患者骨量的丢失程度较非KOA人群低,其可能与KOA的发生发展抑制骨吸收有关。随KOA严重程度的增加,KOA患者骨形成能力减低。

Objective： To explore the impact of knee osteoarthritis （ KOA ） in elderly women on bone mineral density （ BMD ） by comparing ＇and analyzing the BMD, bone metabolic markers of the normal people and patients with various degrees of KOA in postmenopausal period.Method： 166 postmenopausal women were divided into four groups, including normal group, mild group, moderate group and severe group by Lequesne Index text. All the women were examined BMD by Dual energy X-ray absorptiometry, bone metabolic markers （ BAP, CTX-1 ） .Furthermore, patients with the symptoms of KOA were also examined by X-ray on knee joint in erect position.The change of these indexes were observed in different groups.Result： Compared KOA patients in postmenopause with those in normal, the number of people whose T value was less than of equal to -1 were different in each group （ P〈0.05 ） .In terms of BAP, there was significant difference in groups with KOA （ P〈0.05 ） .And there was significant difference of CTX-1 in groups of normal, mild and moderate （P〈0.05） .Conclusion： The KOA patients in the early stage sustain less bone mass loss than those without KOA, which may be associated with KOA inhibiting bone resorption.With the increasing of KOA severity, the bone formation ability reduces.