强直性脊柱炎合并骨质疏松的临床研究

目的 探讨强直性脊柱炎（AS）患者合并骨质疏松症（OP）情况及其与骨代谢、疾病活动性等的关系.方法 ELISA法检测60例AS患者血清骨代谢指标骨特异性碱性磷酸酶（BALP）、抗酒石酸盐酸性磷酸酶异构体5b（TRACP5b）水平,并与正常对照比较;采用双能X线吸收法（DXA）测定腰椎前后位（L2-L4）、双侧股骨颈、大转子的骨密度（BMD）,并与临床指标进行相关分析.结果 60例AS患者OP发生率为35.0%;股骨近端OP发生率明显高于腰椎;AS组[（1.31±O.82）U/L]较正常对照组[（1.06±0.18）U/L]血清TRACP5b水平显著升高（P〈0.05）;AS合并OP者血清BALP水平[（21.65±5.41）U/L]低于非OP者[（32.37±16.5）U/L]（P〈0.05）;股骨近端BMD与病程呈负相关（P〈0.01）.结论 AS患者存在较高的OP发生率,继发OP与骨代谢异常及病程相关,是多因素共同影响的结果.

Clinical study of osteoporosis in patients with ankylosing spondylitis

Objective To investigate the incidence of osteoporosis (OP) in patients with ankylosing spondylitis and the relationship between OP and the clinical data. Methods Serum levels of bone alkaline phosphatase (BALP) and tartrate resistant acid phosphatase 5b (TRACP5b) were detected by enzyme linked immunosorbent assay ( ELISA ) in 60 cases with ankylosing spondylitis, and it was compared with normal controls. Bone mineral density (BMD) was measured through dual-energy X-ray absorptiometry ( DXA), including lumbar ( L2 - L4), bilateral femoral neck and greater trochanter. Some clinical data was collected and analyzed at the same time. Results The incidence of OP in AS patients was 35%, and the incidence of OP in the femoral proximal end was higher than that in lumbar. Compared with normal controls[ ( 1.06 ±0. 18 )U/L ], the levels of serum TRACP5b in AS[ (1.31 ± 0. 82 )U/L] patients was significantly higher ( P <0. 05 ). The levels of serum BLAP in OP combined AS group[ ( 21.65 ± 5.41 ) U/L]were significantly lower than non-OP group[ (32. 37 ± 16. 5 ) U/L] ( P <0. 05 ). The disease duration was negatively correlated with the BMD of femoral neck ( P < 0. 01 ). Conclusions There was higher incidence of OP in AS patients, which were related with the abnormality of bone metabolism and the disease duration.Multiple factors participated in the regulation of bone metabolism of AS.