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目的探讨骨代谢生化指标的检测在糖皮质激素诱导类风湿性关节炎骨质疏松症(osteoporosis,OP)中的作用。方法选择2013年5月-2014年5月在新疆医科大学第一附属医院风湿免疫科住院的55例类风湿性关节炎(rheumatoid arthritis,RA)患者,按入院前是否已经接受糖皮质激素治疗分为治疗组(已接受激素治疗)23例和非治疗组(未接受激素治疗)32例,所有患者均进行骨密度测定及血清25羟维生素D(25OHD)、骨钙素、血钙、血磷和血碱性磷酸酶的检测,并进行比较。结果治疗组骨钙素显著低于非治疗组患者,差异有统计学意义(P<0.01),而两组患者骨密度、血清25OHD、血钙、血磷和血碱性磷酸酶指标差异均无统计学意义(P>0.05)。结论骨代谢生化指标的降低可以较早提示骨代谢的变化,其改变早于骨密度,可以敏感地反映短期内的骨代谢情况,稳定性好,有利于RA患者治疗同时监测糖皮质激素治疗后的骨代谢紊乱情况,对RA患者的早期预防和治疗骨质疏松有指导意义。
Objective To investigate the effects of biochemical markers of bone metabolism on glucocorticoid-induced osteoporosis (OP) in rheumatoid arthritis. Methods From May 2013 to May 2014, 55 patients with rheumatoid arthritis (RA) admitted to Department of Rheumatology, the First Affiliated Hospital of Xinjiang Medical University were treated with glucocorticoid before admission Twenty-three patients in the treatment group (receiving hormone therapy) and 32 patients in the non-treatment group (receiving no hormone therapy) all had bone mineral density (BMD), serum 25-hydroxyvitamin D (25OHD), osteocalcin, And blood alkaline phosphatase detection, and compared. Results The osteocalcin in the treatment group was significantly lower than that in the non-treatment group (P <0.01). There was no difference in BMD, serum 25OHD, serum calcium, serum phosphorus and blood alkaline phosphatase between the two groups Statistical significance (P> 0.05). Conclusion The decrease of biochemical markers of bone metabolism can prompt the change of bone metabolism earlier than before. The change of bone metabolism is earlier than that of bone mineral density. It can reflect the short-term bone metabolism sensitively and has good stability. It is also beneficial to the treatment of RA patients and the monitoring of glucocorticoid treatment Of the bone metabolism disorders, RA patients with early prevention and treatment of osteoporosis is instructive.