绝经后女性类风湿关节炎患者骨密度的临床研究【临床医学专业论文设计】

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1、临床医学论文-绝经后女性类风湿关节炎患者骨密度的临床硏究作者：臧谋圣，张林杰，徐胜前，徐建华，李群【摘要】目的探讨绝经后女性类风湿关节炎（RA）患者骨密度（BMD）的变化及其骨质疏松（0P）的发生情况。方法采用双能X线骨密度仪，测量45例女性RA患者（绝经前26例和绝经后19例）和45例正常女性（绝经前24例和绝经后21例）的前臂、腰椎2〜4以及股骨颈、Ward区和大转子的BMD，并同时测定RA患者各临床及实验室指标。结果19例绝经后女性RA患者屮，11例患者（57.9%）有至少1个检测部位为0P，7例患者（36.8%）表现为至少1个

2、检测部位骨量低下，总体骨量丢失较绝经前RA患者明显（PvO.OOO1），与正常绝经后女性无差别（P>0・05）。除橈骨远端外，绝经后RA患者各测定部位BMD均低于绝经前患者（P<0・05）；绝经后女性RA崽者股骨Ward区和2〜4BMD低于正常绝经后女性（P<0.05），其余各测定部位的BMD与正常绝经后女性间差别无统计学意义（P>0.05）°LogisticRegression分析显示绝经：0R=14.144［（2.303-86.877），P二0.004］为女性RA患者骨质疏松发生的相关因素。结论绝经后女性RA患者的BMD明显降低，

3、骨量丢失较绝经前RA患者明显。绝经和关节炎的严重程度为女性RA患者0P发牛的危险因素。【关键词】类风湿关节炎；骨密度；骨质疏松Abstract:ObjectiveToinvestigatethechangeinbonemineraldensity(BMD)andtheprevalenceofosteoporosis(OP)inpostmenopausalfemalepatientswithrheumatoidarthritis(RA).MethodsBMDofnondominantforearm,1umbarvertebrae(L2・

4、4)andhipweremeasuredbydualenergyXrayabsorptiometryin45femalepatientswithRA(26premenopausal,19postmenopausal)andin45healthyfemalesubjects(24orlaboratoryindexesweresevererthanthatofsimilartothatofnormalpremenopausal,21postmenopausal).ClinicalThetotalbonelossofalsomeasured

5、inthemeantime.ResultspostmenopausalfemalepatientswithRAwaspremenopausalpatients(PvO.OOOl),andwaspostmenopausalfemalesubjects(P>0.05).BMDofal1thedetectedsitesweresignificant1owerinthepostmenopausalfemalepatientswithRAthaninthepremenopausalpatients(P<0.05)exceptBMDofnondo

6、minantforearm.BMDofWarddomainandgreatertrochanterofhipinpostmenopausalfemalepatientswithRAwassignificant1owerthanthatinthenormalpostmenopausalfemale(P<0.05).LogisticregressionanalysisshowedthatmenopausewasafactorcorrelatedwithosteoporosisinfemalepatientswithRA[OR二14.144

7、(2.303-86.877),P=0.004].ConclusionThereisobviouslyreductioninBMDinpostmenopausalfemaleswithRA.Thetotalbonelossisseverer,comparedwiththatofpremenopausalpatients.MenopauseandjointinflammationarcriskfactorswhichhelptodevelopOPinfemalepatientswithRA.Keywords:rheumatoidarthr

8、itis;bonemineraldensity;osteoporosis类风湿关节炎(RheumatoidArthritis，RA)是一种慢性进行性可导致骨质破坏的自身免疫病，文献报道RA患者中骨密度(BoneMiner