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| 外周血RANKL/OPG比值在类风湿关节炎合并股骨头坏死患者中的意义 |
| Association between peripheral blood RANKL/OPG ratio and osteonecrosis of femoral head in patients with rheumatoid arthritis |
| 投稿时间：2015-06-15 |
| DOI：10.3969/j.issn.1000-0399.2016.02.001 |
| 中文关键词: 类风湿关节炎 股骨头坏死 RANKL/OPG比值 骨质疏松 |
| 英文关键词: Rheumatoid Arthritis Necrosis of Femoral Head RANKL/OPG Ratio Osteoporosis |
| 基金项目:安徽省自然科学基金项目(项目编号:1308085MH163)。 |
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| 摘要点击次数: 2009 |
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| 中文摘要: |
| 目的 探讨外周血RANKL和OPG水平的变化在类风湿关节炎(RA)患者合并股骨头坏死(ONFH)中的意义。方法 回顾性分析2010年1月至2013年10月住院的644例RA患者各项临床及实验室指标,并选择同期体检的158例健康者为对照组,所有观察对象均行骨盆平片检查。对比分析两组观察对象股骨和腰椎骨密度及外周血RANKL和OPG水平。结果 RA患者中骨质疏松(OP)和ONFH发生率明显高于对照组(χ2=31.92,P<0.001;χ2=8.71,P=0.003);伴ONFH的RA患者外周血RANKL水平[214.50(384.05%) vs 82.67(78.86%)]、RANKL/OPG比值(0.41 vs 0.27)高于无ONFH的RA患者(P<0.05),且病程、健康状况问卷(HAQ)评分和双手关节Sharp评分均明显高于无ONFH的RA患者(P<0.001)。服用糖皮质激素(GC)的RA患者其ONFH发生率明显高于未服用GC组(χ2=20.62,P<0.001)。logistic regression多元回归结果显示,服用GC、总股骨区OP的发生、外周血RANKL/OPG比值为RA发生ONFH的危险因素。结论 RA患者合并ONFH的发生率高于健康人群,且与GC的使用、总股骨区OP的发生、RANKL/OPG比值升高密切相关,也与RA局部骨侵蚀存在一定的相关性。 |
| 英文摘要: |
| Objective To investigate the effect of peripheral blood RANKL/OPG ratio on osteonecrosis of the femoral head(ONFH) in patients with rheumatoid arthritis(RA).Methods A retrospective analysis of the clinical and laboratory parameters of 644 cases of hospitalized patients with RA from Jan 2010 to Oct 2013 was conducted.A total of 158 normal healthy subjects examined during the same period were collected as the control group.All individuals were performed plain pelvic radiographs, and then their bone mass density(BMD) at femur and lumbar vertebra and their serum levels of RANKL and OPG were compared and analyzed.Results The prevalence of ONFH in the RA patients was significantly higher than that in the healthy controls(5.28% vs 0.00%, χ2=8.71, P=0.003), and the incidence of osteoporosis in the RA patients was also significantly higher(38.27% vs 13.92%, χ2=31.92, P<0.001).The serum levels of RANKL [214.50(384.05) vs 82.67(78.86)] and RANKL/OPG ratio [0.41(1.07) vs 0.27(0.33)] in the RA patients with ONFH were both higher than those without ONFH with statistical differences(P<0.05).Furthermore, the RA patients with ONFH had longer duration of disease, higher health assessment questionnaire(HAQ) scores, and worse hands joint Sharp scores when compared with those without ONFH, and the differences between them were statistically significant(P<0.001).The prevalence of ONFH in the RA patients who taking corticosteroid was significantly higher than that without corticosteroid mediation(9.22% vs 0.88%, χ2=20.62, P<0.001).Results of multiple logistic regression showed that usage of corticosteroid, occurrence of osteoporosis at total femoral area, and the RANKL/OPG ratio were all risk factors for happening of ONFH in patients with RA.Conclusion Prevalence of ONFH in the RA patients is significantly higher than that in the healthy controls, which is closely related with usage of corticosteroid, occurrence of osteoporosis at total femoral area and elevation of serum RANKL/OPG ratio.Meanwhile, there is relationship between local bone erosion and ONFH in the RA patients. |
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