骨代谢标志物在强直性脊柱炎疾病活动性和骨折风险评估中的研究进展

Advances of research in assessing the fracture risk and ankylosing spondylitis activity with bone turnover markers

强直性脊柱炎(ankylosing spondylitis,AS)是一种与HLA-B27相关的病因不明的慢性炎症性免疫疾病,该病易侵犯骶髂关节、脊柱骨突以及外周关节,严重者可有骨质疏松及骨折的风险。对于普通AS患者,如何预估患者罹患骨质疏松、甚至发生骨折的风险,以确定哪些患者能从抗骨质疏松症药物治疗中获得最佳益处,是预防骨折发生、降低患者致残率的必然要求。骨代谢标志物可以反映骨的整体转换率,在AS患者的评估强直性脊柱炎疾病活动性及其分型、预测骨折发生的危险性、观察药物治疗疗效等均有重要意义。因此,笔者对骨代谢标志物与AS患者疾病活动性及其与骨质疏松相关性研究进展作一综述。

Ankylosing spondylitis(AS)is a HLA-B27-related chronic inflammatory-immune disease with unknown etiology,which involves sacroiliac joint,spinal column,and peripheral joint damages.Severe cases may have the risk of osteoporosis(OP)and fracture.In order to minimize the disability rate for general AS patients,it is a prerequisite to estimate the risk of OP or even fracture,and to identify the individuals who can obtain the most benefits from the targeted therapy of OP.Bone turnover markers(BTMs)are typical bone matrix components,which can be measured in blood and urine,secreted by osteoblasts and osteoclasts.BTMs reflect the bone turnover rate and bone formation rate,which is of significant importance to the diagnosis of pathological types of OP,assessment of the fracture risk,and monitoring the curative effect of developing medicine.Therefore,an overview of recent research advances in assessing AS activity and fracture risk with BTMs is provided in this article.