CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者脊柱骨质疏松性骨折(OPF)的危险因素.方法选取2011年2月至2015年3月在淮北市人民医院骨一科RA患者244例.根据是否发生骨质疏松性骨折(OPF)分为OPF组(31例)和非OPF组(213例),观察一般资料、糖皮质激素使用情况、28个关节疾病活动度评分(DAS28)、健康状况问卷(HAQ)情况、C反应蛋白(CRP)、抗环瓜氨酸肽(CCP)抗体、红细胞沉降率(ESR)等.结果 OPF组年龄为(64.3±10.9)岁,病程(9.0±3.3)年,明显高于非OPF组的(57.4±11.2)岁和(6.0 ±2.7)年(P＜0.05);OPF组和非OPF组ESR、CRP、抗CCP抗体、DAS28和HAQ评分比较差异无统计学意义(P ＞0.05);OPF组Sharp评分(56.0±18.4)分、激素使用时间785 d、激素累计量7 100 mg·d,与非OPF组[Sharp评分(86.1 ±17.1)、激素使用时间191 d、激素累计量1 900 mg·d]相比差异有统计学意义,P＜0.05;OPF组股骨颈、Ward区、总股骨区和胸椎2～3骨密度T值分明显低于非OPF组(P＜0.05);非条件Logistic回归显示年龄和骨质疏松是RA患者发生OPF的危险因素.结论年龄、骨质疏松是类风湿关节炎患者发生脊柱骨质疏松性骨折的危险因素.
목적 탐토류풍습관절염(RA)환자척주골질소송성골절(OPF)적위험인소.방법 선취2011년2월지2015년3월재회북시인민의원골일과RA환자244례.근거시부발생골질소송성골절(OPF)분위OPF조(31례)화비OPF조(213례),관찰일반자료、당피질격소사용정황、28개관절질병활동도평분(DAS28)、건강상황문권(HAQ)정황、C반응단백(CRP)、항배과안산태(CCP)항체、홍세포침강솔(ESR)등.결과 OPF조년령위(64.3±10.9)세,병정(9.0±3.3)년,명현고우비OPF조적(57.4±11.2)세화(6.0 ±2.7)년(P＜0.05);OPF조화비OPF조ESR、CRP、항CCP항체、DAS28화HAQ평분비교차이무통계학의의(P ＞0.05);OPF조Sharp평분(56.0±18.4)분、격소사용시간785 d、격소루계량7 100 mg·d,여비OPF조[Sharp평분(86.1 ±17.1)、격소사용시간191 d、격소루계량1 900 mg·d]상비차이유통계학의의,P＜0.05;OPF조고골경、Ward구、총고골구화흉추2～3골밀도T치분명현저우비OPF조(P＜0.05);비조건Logistic회귀현시년령화골질소송시RA환자발생OPF적위험인소.결론 년령、골질소송시류풍습관절염환자발생척주골질소송성골절적위험인소.
Objective To investigate the risk factors of osteoporotic fractures (OPF) in patients with RA.Methods From February 2011 to March 2015,244 patients with rheumatoid arthritis (RA) were treated in Department of Orthopedics,Huaibei People's Hospital,according to the occurrence of osteoporotic fractures (OPF) into the OPF group (n =31) and the non OPF group (n =213),observed two groups general information,glucocorticoid usinge,-28 joint disease activity score (DAS28),health status Questionnaire (HAQ),C-reactive protein (CRP),anti-cyclic citrullinated peptide (CCP) antibody,erythrocyte sedimentation rate (ESR),etc.Results OPF group the mean age and disease duration for (64.3 ± 10.9) years and (9.0 ±3.3) years were significantly higher than that of non OPF group (57.4 ± 11.2) years and (6.0 ± 2.7) years (P ＜ 0.05);OPF group and non OPF group ESR,CRP,anti CCP,HAQ and DAS28 difference was not statistically significant (P ＞ 0.05);OPF group sharp score (56.0 ± 18.4),hormone use time (785 d),and hormone cumulant (7 100 mg · d) were significantly higher than that in non OPF group[sharp score(86.1 ± 17.1),hormone use time(191 d),and hormone cumulant(1 900 mg · d)],the difference was statistically significant (P ＜ 0.05);OPF femoral neck,Ward area,total femur area and thoracic spine 2-3 bone mineral density T value significantly lower than non OPF group (P ＜ 0.05).Conclusion Age and osteoporosis are risk factors for the occurrence of osteoporotic fractures in patients with rheumatoid arthritis,so patients should conduct a risk assessment to guide rational drug use.