Capaci Kazim, Hepguler Simin, Argin Mehmet, Tas Isil
Ege University Medical Faculty, Physical Therapy and Rehabilitation Department, 35100 Bornova, Izmir, Turkey.
Yonsei Med J. 2003 Jun 30;44(3):379-84. doi: 10.3349/ymj.2003.44.3.379.
To compare the bone mineral density (BMD) and determine the frequency of osteoporosis in mild and advanced ankylosing spondylitis (AS) cases. Seventy three patients with AS were enrolled in this study. The BMD was analyzed at the lumbar spine and hip by dual energy X-ray absorptiometry. The patients were diagnosed as being "normal, osteopenia, or osteoporosis" according to the WHO classification. Using the BASRI-lumbar and BASRI-hip scores, the patients were grouped in mild and advanced AS categories. The mean BMD in the lumbar spine and hip of patients with mild and advanced AS was similar (p > 0.05). While 61.6% of the patients were found to have osteopenia or osteoporosis in the lumbar spine, 46.6% had osteopenia or osteoporosis in the total hip. Of the patients with advanced AS 54.3% had osteopenia or osteoporosis in the lumbar spine, 75% in the total hip. Of the patients with mild AS patients had 68.4% osteopenia or osteoporosis in the lumbar spine, and 42.3% in the total hip. The osteopenia or osteoporosis frequency of the mild and advanced cases of AS in the lumbar spine was similar (p > 0.05). In the advanced AS patients, osteopenia or osteoporosis frequency was significantly higher in the total hip than in the mild AS patients (p < 0.05). In conclusion, there was evidence of osteoporosis in both the advanced AS and mild AS patients. The reason why the anteroposterior lumbar DXA results in the advanced AS patients were similar to the mild ones may be due to the existence of syndesmophytes and ligament calcification. In these cases, it is more convenient to use a hip DXA for assessing the extent of osteoporosis.
比较轻度和重度强直性脊柱炎（AS）患者的骨密度（BMD）并确定骨质疏松症的发生率。本研究纳入了73例AS患者。采用双能X线吸收法分析腰椎和髋部的骨密度。根据世界卫生组织的分类，将患者诊断为“正常、骨量减少或骨质疏松”。使用BASRI-腰椎和BASRI-髋部评分，将患者分为轻度和重度AS组。轻度和重度AS患者腰椎和髋部的平均骨密度相似（p>0.05）。虽然61.6%的患者腰椎存在骨量减少或骨质疏松，46.6%的患者全髋存在骨量减少或骨质疏松。重度AS患者中，54.3%的患者腰椎存在骨量减少或骨质疏松，75%的患者全髋存在骨量减少或骨质疏松。轻度AS患者中，68.4%的患者腰椎存在骨量减少或骨质疏松，42.3%的患者全髋存在骨量减少或骨质疏松。轻度和重度AS患者腰椎的骨量减少或骨质疏松发生率相似（p>0.05）。在重度AS患者中，全髋的骨量减少或骨质疏松发生率显著高于轻度AS患者（p<0.05）。总之，重度AS和轻度AS患者均有骨质疏松的证据。重度AS患者前后位腰椎双能X线吸收测定（DXA）结果与轻度患者相似的原因可能是存在韧带骨赘和韧带钙化。在这些情况下，使用髋部DXA评估骨质疏松程度更为方便。
