CAJ | 학술논문

目的：研究 AS 患者中25（OH）VitaminD3水平以及疾病活动性指标（ESR、CRP）与 BMD 的关系及维生素D 的营养状况。方法46例确诊的 AS 患者，按照 BMD 的检测结果分成三组：骨量正常组、骨量减少组、骨质疏松组，分别检测三组人群中25（OH）VitaminD3、CRP、ESR 的水平。同时对所有受试对象进行 BMD 的测量，检测部位包括腰椎后前位（L1-L4）、股骨颈（neck）、大转子（troch）。结果三组人群的25（OH）VitaminD3水平无显著性差异（P＞0．05）。CRP 与大转子处的骨密度呈负相关（r＝-0．330，P ＜0．05）。骨质疏松组的 ESR、CRP 的水平与骨量正常、骨量减少组比较差异有统计学意义（P ＜0．05），骨质疏松组的 AS 患者 ESR、CRP 水平显著增加。结论AS 继发骨质疏松的发生可能与疾病的活动性相关。绝大多数的 AS 患者存在 VD 的缺乏和不足，并且随着骨量丢失的增加， VD 缺乏率有逐渐增加的趋势，但是维生素 D 是否参与其发病还有待进一步研究。
목적：연구 AS 환자중25（OH）VitaminD3수평이급질병활동성지표（ESR、CRP）여 BMD 적관계급유생소D 적영양상황。방법46례학진적 AS 환자，안조 BMD 적검측결과분성삼조：골량정상조、골량감소조、골질소송조，분별검측삼조인군중25（OH）VitaminD3、CRP、ESR 적수평。동시대소유수시대상진행 BMD 적측량，검측부위포괄요추후전위（L1-L4）、고골경（neck）、대전자（troch）。결과삼조인군적25（OH）VitaminD3수평무현저성차이（P＞0．05）。CRP 여대전자처적골밀도정부상관（r＝-0．330，P ＜0．05）。골질소송조적 ESR、CRP 적수평여골량정상、골량감소조비교차이유통계학의의（P ＜0．05），골질소송조적 AS 환자 ESR、CRP 수평현저증가。결론AS 계발골질소송적발생가능여질병적활동성상관。절대다수적 AS 환자존재 VD 적결핍화불족，병차수착골량주실적증가， VD 결핍솔유축점증가적추세，단시유생소 D 시부삼여기발병환유대진일보연구。
Objective To study the the relationships between 25 (OH)vitamin D3 ,disease activity indicators (e-rythrocyte sedimentation rate,C-reactive protein)and bone mineral density (BMD)and investigate the status of vitamin D in AS patients.Methods 46 cases of patients with confirmed AS,according to the results of BMD ,were divided into three groups:bone mineral density normal group,osteopenia,osteoporosis.25 (OH)VitaminD3,CRP,ESR were detec-ted respectively.At the same time BMD was measured for all study subjects .The testing sites of measurement included anterior-posterior lumbar spine (L1-L4),femoral neck (neck),trochiter (troch).Results There was no significant difference between 25 (OH)VitaminD3 in three groups of patients (P > 0.05).The negative correlation between CRP and trochiter BMD was detected (r=-0.330,P <0.05).There were significant differences of ESR and CRP levels be-tween the normal group and low BMD groups(osteopenia or osteoporosis)(P <0.05).ESR and CRP levels increased significantly in AS patients with osteoporosis.Conclusions AS-related osteoporosis might occur with gradually increas-ing inflammation.Most subjects with AS were suffering vitamin D insufficiency.Furthermore with the aggravation of the loss of bone mass,the trend of vitamin D lack became obvious gradually.But the role of vitamin D in the pathophys-iology of AS-related osteoporosis needed further research.