强直性脊柱炎患者骨密度随年龄的变化

Changes with age in bone mineral density of ankylosing spondylitis patients

摘要:

目的 采用双能X线吸收法测量强直性脊柱炎患者（AS）不同部位的骨密度（BMD），探讨其与年龄变化的关系，为临床防治AS患者BMD降低提供参考。方法 选取门诊50例符合纽约诊断标准的AS患者，按年龄≤40岁、年龄＞40岁分为两组，分别检测其侧位腰椎（L1-L4）、股骨颈、髋关节BMD，以T值≤-1.0定义为BMD降低，包括骨量减少（-2.5＜T＜-1.0）与骨质疏松（T≤-2.5）。结果 两组AS患者出现BMD降低的比例均高于正常人，且年龄＞40岁组其腰椎BMD减少的比例高于年龄≤40岁组（P＜0.05），而其腰椎平均T值低于年龄≤40岁组（P＜0.05），在股骨颈测得的BMD、骨质疏松比例两组无明显差异（P＞0.05）。结论 AS患者早期即可出现骨量减少甚至骨质疏松，随着年龄的增长其侧位腰椎BMD降低明显，骨折风险增大。临床上应当提高对AS合并骨质疏松的警惕，及时予补钙等治疗，提高患者的生活质量。

Abstract:

Objective To investigate the relationship of bone mineral density(BMD) with age in ankylosing spondylitis(AS) patients, which might benefit prevention and treatment of low BMD or osteoporosis (OP) in AS. Methods Fifty AS outpatient (modified New York criteria) were selected and divided into two groups by age, ≤40 years and ＞40 years. BMD were measured by dual-energy X-ray absorptiometry, in lumbar (L1-L4), femoral neck and hip. T value not more than -1.0 was defined as lower bone density, including osteopenia (-2.5＜T＜-1.0) and osteoporosis (T≤-2.5). Results Based on measurement of lumbar, percentage of low BMD was higher in two AS groups than normal controls, and was higher in ＞40 years AS group than in ≤40 years group(P＜0.05). T value was lower in ＞40 years AS group than in ≤40 years group (P＜0.05). While based on measurement of femoral neck and hip, the incidences of low BMD and osteoporosis were not significantly different between two AS groups(P＞0.05). Conclusions AS patients may appear osteopenia or osteoporosis at early stage. The incidence of low BMD and the risk of fracture increase with aging. Vigilance to AS complicated with osteoporosis and timely calcium supplement are recommended clinically, to improve the patients￠ quality of life.