绝经后女性类风湿关节炎患者骨密度的影响因素

Influencing factors of bone mineral density in postmenopausal women with rheumatoid arthritis

目的探讨RA活动度、病程以及生物制剂对骨密度的影响。方法选取2013年3月~2016年1月135例绝经后女性RA患者并随访1年。根据是否使用双膦酸盐分为两组。检测患者血清:BGP、β-CTX。计算RA患者疾病活动指数(DAS28评分,CDAI、SDAI)和HAQ评分;用DEXA检测各组受试者腰椎及股骨颈及全髋骨密度(BMD);记录患者是否使用生物制剂治疗。用单因素回归及多因素回归分析各变量和骨密度的关系。结果多元线性回归分析提示病程和股骨颈及全髋的骨密度存在显著关系。生物制剂的使用和骨密度无显著性相关。结论绝经后女性RA患者的髋部骨密度取决于病程,无论是否使用双膦酸盐。生物制剂使用和骨丢失无显著相关性。

Objective To explore the effects of activity and duration of RA and biological agents on bone mineral density. Methods From March 2013 to January 2016, 135 eases of postmenopausal women with RA were selected and followed up for 1 year. Participants were divided into two groups according to whether they used bisphosphonates or not. Serum BGP and β-CTX of patients were detected. The disease activity index （DAS28 score, CDAI, SDAI） and HAQ score of RA patients were calculated. The bone mineral density（BMD） of lumbar vertebrae, femoral neck and total hip were measured by DEXA. Whether the patients were treated with biological agents was recorded. The relationship be- tween variables and bone mineral density was analyzed by univariate and multivariate regression. Results Multiple linear regression analysis showed that there was a significant linear relationship between the course of disease and the bone mineral density of femoral neck and total hip. There was no significant correlation between the use of biological agents and bone mineral density. Conclusion Hip bone mineral density in postmenopausal women with RA is dependent on the course of disease, regardless of whether bisphosphonates are used or not. There was no significant correlation between the use of biological agents and bone loss.