强直性脊柱炎继发骨质疏松患者的骨密度及骨代谢指标变化

Bone density and bone metabolic markers in ankylosing spondylitis patients with osteoporosis

目的观察强直性脊柱炎(AS)合并骨质疏松症患者的骨密度和骨代谢指标变化。方法测定43名AS患者骨密度、血清骨钙素N端中分子(N-MID)、β胶原特殊序列(β-Crosslaps)及尿Ⅰ型胶原C末端肽(CTX-Ⅰ)水平变化,并用AS疾病活动指数(BASDAI)对患者病情进行评分。结果 43例AS中,骨质疏松、骨量减少者分别为13例(30.2%)和20例(46.5%)。AS组血清β-Crosslaps和尿CTX-Ⅰ水平明显高于健康对照组(P<0.01),而N-MID水平差异无统计学意义(P>0.05)。BASDAI>4组的血清β-Crosslaps和尿CTX-Ⅰ水平明显高于BASDAI≤4组,而N-MID水平明显低于BASDAI≤4组(P<0.01)。结论 AS患者存在骨密度减低和骨代谢异常。

Objective To observe the change of bone density and bone metabolic markers in ankylosing spondylitis （AS） patients with osteoporosis. Methods Bath ankylosing spondylitis disease activity index （BASDAI）, bone mineral density （BMD） serum N-MID osteocalcin and β-Crosslaps levels, and urinary collagen type I C-terminal peptide （CTX-I） level were determined in 43 AS cases. Results Osteoporosis and osteopenia were present in 13 （30,2%） and 20 （46.5%） of 43 AS patients, respectively. Serum 13-Crosslaps and urinary CTX-I levels were significantly higher in AS group than those in healthy control group （P〈0.01）, but N-MID content was no significant difference between both groups （P〉0.05）. Compared with BASDAI≤4 group, serum β - Crosslaps and urinary CTX-I levels increased but N-MID content decreased in BASDA/〉 4 group （P〈0.01）. Conclusion There exist BMD decrease and abnormal bone metabolism in AS patients.