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229例类风湿关节炎女性患者的椎体畸形:与临床变量及骨密度的关联

Vertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density.

作者信息

Ørstavik Ragnhild E, Haugeberg Glenn, Uhlig Till, Falch Jan A, Halse Johan I, Høiseth Arne, Lilleås Finn, Kvien Tore K

机构信息

Oslo City Department of Rheumatology, Oslo, Norway.

出版信息

Arthritis Rheum. 2003 Jun 15;49(3):355-60. doi: 10.1002/art.11118.

Abstract

OBJECTIVE

To examine the occurrence of vertebral deformities in female patients with rheumatoid arthritis (RA), and the relationship between vertebral deformities and bone mineral density (BMD) and between vertebral deformities and clinical variables.

METHODS

Lateral radiographs of the spine were obtained in 229 female patients with RA (mean age 63.4 years, range 51.4-73.6 years) recruited from a county RA register. Vertebral deformities were measured semiquantitatively by an experienced radiologist. A clinical examination including core measurements of disease activity and severity was performed, and BMD was measured at the spine (L2-L4) and hip.

RESULTS

According to the statistical analysis, 49 patients were considered to have relevant vertebral deformities. The occurrence of vertebral deformities was independently associated with age, long-term corticosteroid use, and previous nonvertebral fracture, as well as reduced BMD. Our results failed to show any independent relationship between vertebral deformities and the activity or severity of disease.

CONCLUSION

Corticosteroid use is an important marker of established osteoporosis in patients with RA. Additionally, there seems to be a consistent relationship between BMD and vertebral deformities in this patient group.

摘要

目的

研究类风湿关节炎(RA)女性患者椎体畸形的发生率,以及椎体畸形与骨密度(BMD)之间、椎体畸形与临床变量之间的关系。

方法

从一个县级RA登记处招募了229名女性RA患者(平均年龄63.4岁,范围51.4 - 73.6岁),获取其脊柱侧位X线片。由一名经验丰富的放射科医生对椎体畸形进行半定量测量。进行了包括疾病活动度和严重程度核心指标的临床检查,并测量了脊柱(L2 - L4)和髋部的骨密度。

结果

根据统计分析,49名患者被认为存在相关椎体畸形。椎体畸形的发生与年龄、长期使用皮质类固醇、既往非椎体骨折以及骨密度降低独立相关。我们的结果未显示椎体畸形与疾病活动度或严重程度之间存在任何独立关系。

结论

使用皮质类固醇是RA患者已确诊骨质疏松的重要标志。此外,在该患者群体中,骨密度与椎体畸形之间似乎存在一致的关系。

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