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1、652中国骨质疏松杂志2009年9月第15卷第9期ChinJOsteoporos,September2009,Vol15,No.9#论著#OPGPRANKL系统在类风湿关节炎中的变化及其对骨质疏松的影响陆竞秋王玉徐胜前中图分类号:R593122文献标识码:A文章编号:1006-7108(2009)09-0652-05摘要:目的探讨类风湿关节炎(RA)患者外周血核因子JB受体活化因子配体(RANKL)和护骨素(OPG)水平的变化及其对RA患者骨质疏松的影响。方法采用ELISA测定64例RA患者和60例正常人外周
2、血中RANKL和OPG水平,采用双能X线骨密度吸收仪测定骨密度,分析RA患者中RANKL和OPG水平的变化与RA患者骨密度、骨质疏松发生之间的相关性。结果¹和正常组相比,RA组外周血OPG水平明显降低,RANKL水平明显升高,OPGPRANKL比值明显降低(P<010001)。ºRA患者各测定部位的骨密度均明显低于正常组(P<010001),其骨质疏松症发生率为3519%,明显高于正常组中的1510%(P<010001)。»RA患者外周血OPG水平与年龄呈负直线相关(P<010001),与各测定部位骨密度呈正
3、直线相关(P<0105~010001)。RA患者外周血RANKL水平与年龄呈正直线相关(P<010001),与各测定部位骨密度呈负直线相关(P<0105~010001)。RA患者外周血OPGPRANKL水平与关节肿胀指数、关节压痛指数、HAQ积分呈正直线相关(P<0105~01001),与骨密度无相关(P>0105)。¼LogisticRegression多元回归法分析显示:外周血RANKL水平为RA患者中骨质疏松发生的独立的、强烈的危险因素,OR=126142,CI95%:37187~185136。结论RA
4、患者外周血OPG水平明显降低,RANKL水平明显升高,它们的变化与骨密度密切相关。外周血RANKL水平升高为RA患者中骨质疏松发生的独立危险因素。关键词:护骨素;核因子JB受体活化因子配体;类风湿关节炎;骨质疏松;骨密度DOI:10.3969Pj.issn.1006-7108.2009.09.007ChangeofOPGPRANKLsysteminpatientswithrheumatoidarthritisanditsinfluenceonosteoporosisLUJingqiu,WANGYu,XUShe
5、ngqian.DepartmentofRheumatism,TheFirstAffiliatedHospitalofAnhuiMedicalUniversity,Hefei230022,ChinaAbstract:ObjectiveTodeterminethelevelofOPGandRANKLinperipheralbloodofrheumatoidarthritis(RA)andnormalcontrols.StudyingthechangeofOPGPRANKLsystemanditsinfluence
6、onosteoporosisinRA.MethodsAtotalof64patientswithRAand60normalcontrolswereinvolved.ThelevelofOPGandRANKLweremeasuredbyELISA.Bonemineraldensity(BMD)ofnon-dominantforearm,lumbarvertebrae(L1-4)andhipweremeasuredbydualenergyX-rayabsorptiometry.Results(1)Compared
7、withnormalcontrols,thelevelofOPGandOPGPRANKLinRAdecreasedobviously,thelevelofRANKLinRAincreasedsignificantly(P<010001).(2)BMDofalldetectedregioninRAreducedmoresignificantlythanthatinnormalcontrols(P<010001).Therewasahigherincidenceofosteoporosisinpatientswi
8、thRA(3519%)thanthatinnormalcontrols(1510%)(P<010001).(3)TherewasanegativelinecorrelationbetweenageandthelevelofOPGinRA(P<010001).TherewerepositivelinecorrelationsbetweenBMDandthelevelofOPGinRA(P<0105-0
