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目的 了解系统性红斑狼疮 (SLE)患者骨矿物质密度 (BMD)的变化 ,并讨论疾病的病情和激素对骨密度的影响。方法 测定健康对照组、初诊SLE组 (A组 )、SLE激素治疗组 (B组 )的BMD、血钙、磷、骨特异性碱性磷酸酶 (ALP)和甲状旁腺激素 (PTH)。并将B组病人分为骨质疏松组和非骨质疏松组 ,对两组的病程、体重指数、发病年龄、疾病的活动指数 (SLEDAI)、系统损害的指数(SLICC/ACRDI)、激素的累积剂量和当前剂量进行统计学分析。结果 A组与正常对照组比较各项指标差异无显著性 (P >0 0 5 ) ;B组腰椎BMD、骨特异性ALP均显著低于正常对照组 (P <0 0 5 ) ,PTH显著高于正常对照组 (P <0 0 5 )。B组骨质疏松的发生率 17 4%。骨质疏松组与非骨质疏松组比较有较长的病程 (P <0 0 1)、较高的累积激素用量 (P <0 0 1)和较高的SLICC/ACRDI (P <0 0 5 )。结论 骨质疏松是年轻的SLE患者的常见病变 ,疾病的病程越长和系统损伤指数越高伴随骨质疏松发生的危险越大 ,但激素的影响与骨质疏松的发生是有关的。
Objective To investigate the changes of bone mineral density (BMD) in patients with systemic lupus erythematosus (SLE) and to discuss the effects of disease and hormone on bone mineral density. Methods BMD, serum calcium, phosphorus, bone specific alkaline phosphatase (ALP) and parathyroid hormone (PTH) in healthy control group, newly diagnosed SLE group (A group) and SLE hormone treated group (B group) The patients in group B were divided into osteoporosis group and non-osteoporosis group. The duration of disease, body mass index, age of onset, disease activity index (SLEDAI), index of systemic injury (SLICC / ACRDI) The cumulative dose and the current dose were statistically analyzed. Results There was no significant difference in each index between group A and control group (P> 0.05). BMD and bone specific ALP in group B were significantly lower than those in control group (P <0.05), and PTH was significantly higher In normal control group (P <0 05). The incidence of osteoporosis in group B was 17.4%. Compared with non-osteoporosis group, osteoporosis group had longer course (P <0.01), higher cumulative hormone dosage (P <0.01) and higher SLICC / ACRDI (P <0.05 ). Conclusion Osteoporosis is a common disease in young patients with SLE. The longer the disease duration and the higher systemic injury index, the greater the risk of osteoporosis. However, the effect of hormones is related to the occurrence of osteoporosis.