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类风湿关节炎骨质疏松的组织形态计量学研究

[Histomorphometric study of osteoporosis in rheumatoid arthritis].

作者信息

Sugita T

机构信息

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi.

出版信息

Ryumachi. 1995 Feb;35(1):62-71.

PMID:7732492
Abstract

A histomorphometric study of osteoporosis in rheumatoid arthritis was performed on thirty-eight specimens from the proximal tibial metaphysis, which were obtained during total knee arthroplasty. Fourteen specimens from the proximal tibial metaphysis of osteoarthritis patients were also histomorphometrically studied, and the osteoporosis in rheumatoid arthritis was compared with it in osteoarthritis. In nine rheumatoid arthritis patients, specimens from the iliac bone were obtained, and the difference between the generalized osteoporosis and the juxta-articular osteoporosis was evaluated. The proximal tibial metaphysis in rheumatoid arthritis was usually represented by a fairly low bone area and by thin mean trabecular thickness. No correlations were seen between histomorphometric parameters and the age at operation, the age of onset and the duration of disease. However, in patients of long duration (over 20 years), the bone area was very low and mean trabecular thickness was thin. In one parameter (scalloped surface) which shows bone resorption, there was a high correlation between generalized osteoporosis and juxta-articular osteoporosis in rheumatoid arthritis. There was no significant difference between rheumatoid arthritis and osteoarthritis in bone area and mean trabecular thickness. However, the scalloped surface of rheumatoid arthritis was significantly higher than it of osteoarthritis.

摘要

对全膝关节置换术中获取的38个胫骨近端干骺端标本进行了类风湿关节炎骨质疏松的组织形态计量学研究。还对14个骨关节炎患者胫骨近端干骺端标本进行了组织形态计量学研究,并将类风湿关节炎的骨质疏松与骨关节炎的进行了比较。在9例类风湿关节炎患者中,获取了髂骨标本,并评估了全身性骨质疏松与关节周围骨质疏松之间的差异。类风湿关节炎患者的胫骨近端干骺端通常表现为骨面积相当低且平均小梁厚度薄。组织形态计量学参数与手术年龄、发病年龄和病程之间未见相关性。然而,病程较长(超过20年)的患者,骨面积非常低且平均小梁厚度薄。在一个显示骨吸收的参数(扇形表面)上,类风湿关节炎的全身性骨质疏松与关节周围骨质疏松之间存在高度相关性。类风湿关节炎和骨关节炎在骨面积和平均小梁厚度方面无显著差异。然而,类风湿关节炎的扇形表面明显高于骨关节炎的。

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