原发性胆汁性胆管炎女性患者骨量异常的临床特点

Clinical characteristics of female patients with primary biliary cholangitis and abnormal bone mineral density

目的探讨原发性胆汁性胆管炎(PBC)女性患者骨量异常的临床特点。方法回顾性分析2019年2月至2022年10月在北京协和医院风湿免疫科门诊就诊的50岁以上、骨密度资料完整的PBC女性患者资料。根据患者骨密度水平分为骨量正常和骨量异常组,分析比较两组患者临床特点。结果纳入54例PBC患者,其中34例骨量异常(20例骨量减少,14例骨质疏松),20例骨量正常。PBC患者骨质疏松症(OP)的好发部位主要为腰椎。骨量正常组与骨量异常组年龄、生化指标、IgM水平、血沉、自身抗体阳性率等比较,差异均无统计学意义(P>0.05)。相较于骨量正常组,骨量异常组患者对熊去氧胆酸(UDCA)应答不良发生率更高(0.0%vs.20.6%,P=0.038)。结论PBC女性患者发生骨量异常常见,且这些患者更容易出现在UDCA应答不良的情况下。

Objective To explore the clinical characteristics of female patients with primary biliary cholangitis(PBC)and abnormal bone mineral density.Methods We retrospectively analyzed the medical records of over 50-year-old postmenopausal women with PBC who visited Peking Union Medical College Hospital’s outpatient clinic from February 2019 to October 2022 with complete bone mineral density(BMD)data.The patients were divided into two groups according to the levels of bone mineral density.The age,sex,clinical manifestations,laboratory data,and treatment plans of the two groups were analyzed and compared.Results A total of 54 PBC patients met the inclusion criteria,including 20 patients with osteopenia,14 patients with osteoporosis,and 20 patients with normal bone mineral density.The most common site of osteoporosis in PBC patients is lumbar spine.There were no significant differences in age,biochemical indexes,IgM,ESR,AMA,anti-gp210 antibody and anti-Sp100 antibody between the normal BMD group and the abnormal BMD group(P>0.05).Compared with the normal BMD group,the incidence of poor ursodeoxycholic(UDCA)response in the BMD abnormal group was higher(0.0%vs.20.6%,P=0.038).Conclusion Abnormal BMD is more common in PBC patients with poor UDCA response.