25-羟-维生素D与类风湿患者骨质疏松的相关性分析

Correlation between 25-hydroxy-vitamin D levels with rheumatoid osteoporosis

目的探讨25-羟-维生素D(25OHD)水平与类风湿患者骨质疏松的相关性并分析其临床意义。方法选择类风湿患者98例,根据类风湿病情活动性评分(DAS28评分),将所有患者分为稳定组(51例)和活动组(47例),分别进行25OHD和骨密度测定,并进行双手X光片检查。结果活动组患者25OHD水平较稳定组显著下降(P<0.05),活动组全髋骨密度、股骨颈骨密度值较稳定组显著下降(P<0.05),活动组腰椎(L1～L4)虽较稳定组下降,但无统计学差异(P>0.05),25OHD与L1～L4骨密度无明显相关性,与全髋及股骨颈骨密度呈显著正相关(P<0.05,P<0.01),25OHD与骨侵蚀及骨狭窄的Sharp评分呈显著负相关(P<0.01,P<0.05)。结论 25OHD有助于评估类风湿患者骨质疏松病情且与骨质疏松程度及类风湿病情活动程度密切相关。

Objective To investigate the correlation between 25 - hydroxy - vitamin D（25OHD） levels with rheumatoid osteopo- rosis and its clinical significance. Methods 98 cases of rheumatoid patients were divided into stable groups（51 cases） and active group（47 cases ）according to DAS28 score. 25OHD,bone density and hands X-ray film examination were determined. Results In patients of active group, 25OHD was significantly decreased, compared with that of stable group（P〈0.05）, bone density of the to- tal hip and femoral neck BMD ih active group were also significantly lower than those in stable group（P〈0.05）, bone density of lumbar spine（L1-L4） in active group was not with significant difference with stable group（P〈0.05）. 25OHD and L1-L4 bone den- sity were significantly positively correlated with total hip and femoral neck（P〈0.05,P〈0.01） ,and 25OHD were negatively corre- lated with bone erosion and bone narrow Sharp score（P〈0.01 ,P〈0.05）. Conclusion 25OHD could contribute to the assessment of patients with rheumatoid osteoporosis and might be closely related to the degree of osteoporosis and the degree of rheumatoid activity.