110例强直性脊柱炎患者骨密度下降的特征及其危险因素

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摘要目的分析强直性脊柱炎(AS)患者骨密度下降的临床特征及其危险因素。方法回顾2017-01至2023-11联勤保障部队第962医院收治的AS患者110例。应用双能X线吸收法测定骨密度并进行分组,分为正常组(T值＞-1)和下降组(T值≤-1)。采用单因素分析骨密度下降的特征,采用多因素logistic分析骨密度下降的危险因素。结果 AS患者年龄中位数25.50(21.00,32.00)岁,病程中位数1.00(0.70,3.00)年,男109例,女1例。骨密度正常74例,骨密度下降36例,其中低骨量32例,骨质疏松4例。接受重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白治疗62例。单因素分析提示年龄、病程、C反应蛋白、红细胞沉降率与骨密度下降相关(P<0.05),多因素logistic分析提示年龄(OR=1.14,95%CI:1.05～1.25)、C反应蛋白(OR=1.09,95%CI:1.02～1.15)、红细胞沉降率(OR=1.03,95%CI:1.00～1.07)是骨密度下降的风险因素,应用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白(OR=0.27,95%CI:0.10～0.76)是骨密度下降的保护性因素。结论年龄、C反应蛋白、红细胞沉降率是AS患者骨密度下降的危险因素,应用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白是骨密度下降的保护性因素。

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	张强
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关键词 ：强直性脊柱炎, 骨密度, 骨质疏松, 双能X线吸收测定法, 危险因素

Abstract：Objective To analyze the clinical characteristics and risk factors of decreased bone mineral density (BMD) in patients with ankylosing spondylitis (AS). Methods A total of 110 AS patients admitted to the 962nd Hospital of PLA Joint Logistics Support Force from January 2017 to November 2023 were reviewed. DXA method was used to measure BMD and the patients were divided into normal group(T-score＞-1) and decreased group(T-score≤-1).The characteristics associated with decreased BMD were analyzed using univariate analysis, and the risk factors of decreased BMD were examined using multivariate logistic regression analysis. Results The median age of AS patients in Heilongjiang Province was 25.50(21.00,32.00) years,and the median disease duration was 1.00(0.70,3.00) years, with 109 male and 1 female. BMD was normal in 74 cases, and BMD decreased in 36 cases, including low bone mass in 32 cases and osteoporosis in 4 cases. A total of 62 cases received recombinant human tumor necrosis factor receptor type Ⅱ antibody fusion protein. Univariate analysis showed that age, disease course,CRP,and ESR were associated with BMD decrease(P<0.05). Multivariate logistic analysis indicated that age(OR=1.14,95%CI:1.05～1.25),CRP(OR=1.09,95%CI:1.02～1.15),and ESR(OR=1.03,95%CI:1.00～1.07)were risk factors for BMD decrease,and recombinant human tumor necrosis factor receptor type II antibody fusion protein(OR=0.27,95%CI:0.10～0.76)was a protective factor against BMD decrease. Conclusions Age,CRP and ESR are risk factors for BMD decrease in patients with AS, while recombinant human tumor necrosis factor receptor type Ⅱ antibody fusion protein acts as a protective factor against BMD decrease.

Key words： ankylosing spondylitis bone mineral density osteoporosis DXA risk factor

收稿日期: 2023-11-16

ZTFLH:

R593.23

基金资助:哈尔滨市科技计划项目(ZC2023ZJ004022)

通讯作者: 邓伟哲,E-mail:deng-wz@163.com

作者简介: 张强,硕士,主治医师。

引用本文:

张强, 邓伟哲, 魏博, 沈正东, 张皓. 110例强直性脊柱炎患者骨密度下降的特征及其危险因素[J]. 武警医学, 2024, 35(6): 488-492. ZHANG Qiang, DENG Weizhe, WEI Bo, SHEN Zhengdong, ZHANG Hao. Characteristics and risk factors of bone mineral density decrease in 110 patients with ankylosing spondylitis: a retrospective study. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(6): 488-492.

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https://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 https://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I6/488

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