女性系统性红斑狼疮患者骨密度与疾病活动性关系研究

目的 探讨系统性红斑狼疮（SLE）患者骨密度与疾病活动性关系.方法 选择92例SLE患者和92例健康对照,均为女性.检测所有纳入对象血清25（OH）D水平.采用SLE疾病活动指数（SLEDAI）评价SLE患者病情活动性,并根据SLEADI评分分为非活动组（n=26）、轻度活动组（n=35）、中度活动组（n=26）、重度活动组（n=5）,采用骨密度仪测量SLE患者双侧股骨颈、股骨大转子、全髋、腰椎L1-L4的骨密度,并进行统计分析.结果 SLE患者血清25（OH）D水平为23.82±5.92 ng/ml,健康对照者为44.82±7.92 ng/ml,存在显著差异（P〈0.001）;重度活动组血清25（OH）D水平显著低于轻度活动组和非活动组（P均〈0.05）.重度活动组患者左右侧股骨颈、左右侧大转子显著低于非活动组和轻度活动组.重度活动组左右侧全髋关节骨密度显著低于非活动组（P均〈0.05）.相关分析发现左右侧股骨颈、左右侧大转子、全髋关节骨密度与SLEDAI评分具有较好的相关性.结论 女性SLE患者维生素D水平降低及骨密度降低与SLE疾病活动性存在关联.应积极防治SLE患者骨密度降低及骨质疏松的发生.

Study on relationship between bone mineral density and disease activity in women with systemic lupus erythematosus.

Objective To explore the relationship between bone mineral density and disease activity in patients with systemic lupus ery thematosus （SLE）. Methods A total of 92 patients with SLE and 92 healthy controls were allocated to this study. Serum level of 25 （OH） D had been detected in all patients and controls. The disease activity index of SLE （SLEDAI） had been applied for evaluation of disease activity in patients with SLE according to SLEADI scores, and they were divided into inactive group （ n = 26 ） , mildly active group （ n = 35 ）, moderately ac tive group （ n = 26 ） and severely active group （ n = 5 ）. Bone mineral density of bilateral femoral neck, trochanter, total hip, lumbar spines L1 L4 were measured in patients with SLE and the results of all above parameters were statistically analyzed. Results The average serum level of 25 （OH） D in patients with SLE was 23.82 ±5.92 ng/ml, and it in healthy controls was 44.82 ± 7.92 ng/ml, there was a significant difference （ P 〈 0. 001 ） between them. The average serum level of 25 （OH） D in severely active group was significantly lower than that of mildly active group and inactive group （ P 〈0.05 ）. Bone mineral density of left and right side femoral neck and greater trochanter in severely active group was signif icantly lower than that of inactive group and mildly active group. Bone mineral density of left and right side total hip in severely active group was significantly lower than that of inactive group （ P 〈 0.05 ）. Analysis showed bone mineral density of left and right side femoral neck, greater tro chanter and total hip had a good correlation with SLEDAI scores. Conclusion In patients with SLE, there is an association with lower level of vi tamin D, bone mineral density and disease activity of SLE. Prevention and treatment should be taken for patients with SLE in order to actively re duce the decrease of bone mineral density and occurrence of osteoporosis.