类风湿关节炎合并骨质疏松患者骨代谢及炎症因子变化研究

The study on the bone metabolism and the change of inflammatory factors in patients with rheumatoid arthritis associated with osteoporosis

目的探讨类风湿关节炎(RA)合并骨质疏松(OP)患者骨代谢及炎症因子的变化。方法将90例RA患者按照是否合并骨质疏松分为OP组(50例)和非OP组(40例),另选取同期40例健康体检者作为对照组。采用酶联免疫吸附法(ELISA)测定骨代谢指标骨保护素(OPG)、骨钙素(BGP)以及炎症因子白介素(IL)-1β、C反应蛋白(CRP)的水平,比较各组骨代谢及炎症因子水平差异情况。结果 RA患者OP发生率为55.56%,女性OP发生率明显高于男性(P<0.05),其中绝经后患者OP发生率明显高于绝经前患者(P<0.05);与对照组相比,OP组和非OP组患者骨代谢指标血清OPG水平显著降低(P<0.05),BGP水平显著升高(P<0.05),OP组和非OP组炎症因子指标IL-1β、CRP水平均显著升高(P<0.05);与非OP组相比,OP组患者血清OPG、IL-1β、CRP水平明显高于非OP组(P<0.05)。结论 RA患者存在较高的OP发生率,且合并OP患者OPG、IL-1β、CRP水平明显高于未合并OP患者,OP的发生与较高的骨转换率有关。

Objective To investigate the bone metabolism and the change of inflammatory factors in patiente with rheumatoid arthritis associated with osteoporosis. Methods According to whether associated with osteoporosis, a total of 90 rheumatoid arthritis patients were divided into OP group （ n = 50） and NOP group （ n = 40） , and 40 healthy adults were regarded as control group during the same period. Enzyme - linked immunosorbent assay （ELISA） were performed to determin bone metabolism （OPG and BGP） and inflammatory factors （IL - 1β and CRP） , the levels of OPG, BGP, IL - 1β and CRP were compared between groups. Results The OP incidence was 56. 67% in RA patients, the OP incidence of the female was higher than that in the male （ P 〈 0. 05） , and the OP incidence of postmenopausal was higher than that in the premenopausal （ P 〈 0. 05）. Compared with control group, the level of OPG decreased significantly and the levels of BGP, IL - 1β and CRP were increased significantly in OP and NOP group （ P 〈 0. 0 5） . Compared with NOP group, the level of OPG, IL - 1β and CRP were increased more significantly in OP group （ P 〈 0. 05 ） . Conclusion RA patients have a higher incidence of OP, and the levels of OPG, IL - 1β and CRP were higher in the OP patients than those in the NOP patients, the formation of osteoporosis is related with high bone turn - over rate in the RA patients.