Will R, Palmer R, Bhalla A K, Ring F, Calin A
Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath.
Lancet. 1989;2(8678-8679):1483-5. doi: 10.1016/s0140-6736(89)92932-2.
Patients with severe ankylosing spondylitis of long duration often have spinal osteoporosis secondary to ankylosis and immobility. Bone mineral density of defined regions of the lumbar spine, femoral neck, and carpus was measured in 25 men who met accepted diagnostic criteria for ankylosing spondylitis but had early disease, with normal mobility and no, or very minor, radiological evidence of lumbar spine involvement. Compared with age-matched male controls, patients with ankylosing spondylitis had a significantly lower hydroxyapatite density in the lumbar spine (mean [SD] 0.82 g/cm2 [0.12] vs 0.91 g/cm2 [0.11]) and in the femoral neck (0.83 g/cm2 [0.11] vs 0.92 g/cm2 [0.11]). There was no significant difference in carpal bone mineralisation density. The pattern of bone loss in these patients indicates early loss of trabecular bone in ankylosing spondylitis, possibly from a systemic cause, but biochemical indices of calcium turnover were similar in patients and controls.
患有长期严重强直性脊柱炎的患者常继发于关节强直和活动受限而出现脊柱骨质疏松。对25名符合强直性脊柱炎公认诊断标准但处于疾病早期、活动正常且无或仅有非常轻微腰椎受累影像学证据的男性患者，测量其腰椎、股骨颈和腕骨特定区域的骨矿物质密度。与年龄匹配的男性对照组相比，强直性脊柱炎患者的腰椎羟基磷灰石密度（均值[标准差]0.82 g/cm²[0.12] 对比 0.91 g/cm²[0.11]）和股骨颈羟基磷灰石密度（0.83 g/cm²[0.11] 对比 0.92 g/cm²[0.11]）显著更低。腕骨矿化密度无显著差异。这些患者的骨质流失模式表明强直性脊柱炎患者早期出现小梁骨丢失，可能由全身性原因导致，但患者和对照组的钙周转生化指标相似。
