强直性脊柱炎患者不同部位骨密度精确性比较及临床意义

Comparison of bone mineral density in different anatomical locations of ankylosing spondylitis patients and its clinical significance

目的比较强直性脊柱炎(AS)不同部位骨密度(BMD)测量精确性。方法对27例AS均行双能X线吸收法(DEXA)测定BMD,测定并记录腰椎、股骨颈和桡骨远端BMD Z值。记录患者病程,根据病程将患者分为A组(早期组,病程<10年)和B组(晚期组,病程≥10年)。结果 A、B组腰椎BMD Z值比较,差异有统计学意义(P<0.05),股骨颈与桡骨远端BMD Z值2组间比较,差异无统计学意义(P>0.05)。A组腰椎BMD更低,更能反映患者的低骨量状况;B组腰椎BMD增高,股骨颈BMD更能反映患者的低骨量状况。结论在早期AS患者中,腰椎BMD具有更好的精确性,更能准确反映其低骨量状态;但在晚期AS患者,腰椎BMD精确性降低,股骨颈BMD更能准确地反映其低骨量状态。

Objective To compare the hone mineral density （BMD） in different anatomical locations of ankylosing spandyhtis （AS） patients. Methods Twenty seven AS patients were included. The BMD was measured by the dual-energy X-ray abserptiometry （DEXA）. The Z-scores of BMD in lumbar spine, femoral neck and distal radius were measured and recorded. According to the disease duration, the patients were divided into group A （early stage group, disease duration 〈10 years） and group B （late stage group, disease duration ≥ 10 years）. Results The Z scores of BMD in lumbar spine were significant different between group A and group B（P 〈0.05）. The Z scores of BMD in femoral neck and distal radius showed no significant difference between the two groups（P 〉0.05）. In group A, the patients had a lower BMD at lumbar spine and it＇s more sensitive in detecting bone loss in AS patients. In contrast, the lumbar BMD increased in group B, the BMD at the femoral neck was more sensitive in detecting bone loss in AS patients. Conclusion The BMD of the lumbar spine is more accurate in detecting bone loss in the early-stage AS patients, while the BMD of the femoral neck is more precise in the late-stage AS patients.