血友病性关节炎与骨质疏松症的关系研究

目的:探讨血友病性关节炎与骨质疏松症的关系.方法:回顾性分析2019年12月至2020年12月收治的40例男性血友病性关节炎患者(血友病性关节炎组)和60例门诊健康体检男性(健康体检组)的病例资料.比较2组受试者的血清骨代谢指标及血液生化指标,前者包括25-羟基维生素D、甲状旁腺激素、总Ⅰ型胶原氨基端前肽(total ...

The relationship between hemophilic arthritis and osteoporosis:a clinical study

Objective:To explore the relationship between hemophilic arthritis(HA)and osteoporosis(OP).Methods:The medical records of 40 HA male patients(HA group)and 60 healthy male volunteers(healthy group)recruited from December 2019 to December 2020 were analyzed retrospectively.The serum markers of bone metabolism including 25-hydroxy vitamin D(25(OH)D),parathyroid hormone(PTH),total N-terminal propeptide of typeⅠcollagen(TPⅠNP),osteocalcin(OCN),calcitonin, β-C-terminal telopeptide of typeⅠcollagen(β-CTX)and the blood biochemical indexes including calcium(Ca),phosphorus(P),alkaline phosphatase(ALP),supersensitive C-reaction protein( SCRP) and erythrocyte sedimentation rate( ESR) were compared between the 2 groups. The T values of bone mineral density( BMD) of left femoral neck( FN) and lumbar vertebra( LV) from L₁ to L₄ were compared between the 2 groups. According to the degree of HA,the 40 patients were divided into mild group( 10 cases),moderate group( 16 cases) and severe group( 14 cases),and the T values of BMD of left FN and LV from L₁ to L₄ were compared between the 2 groups. Results:(1)The serum levels of TPⅠNP,OCN and β-CTX were higher in HA group compared to healthy group( 76. 8 ± 31. 1 vs 56. 9 ± 16. 4 ng/m L,t =-3. 391,P = 0. 001;19. 8 ± 6. 1 vs16. 0 ± 4. 5 ng/m L,t =-3. 944,P = 0. 001;780. 6 ± 336. 1 vs 528. 9 ± 174. 4 pg/m L,t =-4. 489,P = 0. 001). There was no statistical difference in the serum levels of 25( OH) D,PTH and calcitonin between the 2 groups( 20. 7 ± 10. 3 vs 19. 2 ± 8. 4 ng/m L,t = 0. 814,P =0. 418;39. 1 ± 18. 0 vs 40. 2 ± 12. 3 pg/m L,t =-1. 175,P = 0. 240;2. 5 ± 2. 8 vs 2. 9 ± 2. 4 pg/m L,t =-1. 468,P = 0. 142).(2)The serum level of Ca was lower and the serum level of SCRP was higher in HA group compared to healthy group( 2. 28 ± 0. 12 vs 2. 33 ±0. 11 mmol/L,t =-2. 089,P = 0. 039;7. 99 ± 12. 85 vs 3. 42 ± 4. 51 mg/L,t =-2. 232,P = 0. 026). There was no statistical difference in the ESR and the serum levels of P and ALP between the 2 groups( 5. 13 ± 6. 77 vs 5. 47 ± 13. 87 mm/h,t =-1. 660,P = 0. 097;1. 21 ±0. 19 vs 1. 23 ± 0. 22 mmol/L,t =-0. 631,P = 0. 529;74. 78 ± 12. 52 vs 76. 40 ± 16. 30 unit/L,t =-0. 493,P = 0. 622).(3)The T value of BMD of FN was smaller in HA group compared to healthy group(-1. 18 ± 1. 17 vs 0. 48 ± 1. 21,t =-5. 814,P = 0. 001). There was no statistical difference in the T value of BMD of LV from L₁ to L₄ between the 2 groups( 0. 04 ± 1. 25 vs 0. 17 ± 0. 93,t =-1. 577,P =0. 115). There was no statistical difference in the T value of BMD of FN among mild group,moderate group and severe group(-1. 09 ±1. 22,-0. 87 ± 1. 31,-1. 78 ± 0. 85,F = 2. 424,P = 0. 103). There was statistical difference in the T value of BMD of LV from L₁ to L₄ among mild group,moderate group and severe group in general( 0. 01 ± 1. 23,0. 41 ± 1. 44,-0. 73 ± 0. 81,F = 3. 277,P = 0. 049). Further pairwise comparison showed that the T value of BMD of LV from L₁ to L₄ was larger in mild group compared to severe group,and there was no statistical difference between mild group and moderate group as well as between mild group and severe group( P = 0. 700,P = 0. 138).Conclusion: HA may cause secondary OP,but there is no clear relationship between the degree of HA and the degree of OP.