摘要
目的探讨补充活性维生素D对于骨量减少的强直性脊柱炎(AS)患者骨代谢标志物、骨密度及炎性指标的影响。方法选取骨量减少的AS患者60例为研究对象,同期健康体检者20例作为健康组,比较两组受试者血清骨特异性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶异构体-5b(TRACP-5b)、25-(OH)D3的水平。将上述AS患者随机分为治疗组和对照组,每组30例,对照组口服美洛昔康、柳氮磺吡啶、碳酸钙,治疗组在此基础上加用骨化三醇口服。比较2组治疗前后BALP、TRACP-5b、25-(OH)D3,骨密度(BMD)以及红细胞沉降率(ESR)、C反应蛋白(CRP)等指标的变化水平。结果 AS组BALP、TRACP-5b高于健康组,25-(OH)D3低于健康组(P<0.05)。治疗组和对照组治疗后血清BALP、25-(OH)D3水平均有升高(P<0.05),TRACP-5b水平均有下降(P<0.05);治疗组BALP及25-(OH)D3治疗前后差值高于对照组(P<0.05)。6个月后治疗组复查腰椎、大转子、转子间BMD较对照组均有不同程度的提升(P<0.05),5例骨量恢复正常;对照组6个月后BMD变化不明显;治疗组治疗前后腰椎、大转子、转子间BMD变化差值均高于对照组(P<0.05);治疗组与对照组ESR、CRP及BASDAI评分较前均有所降低(P<0.05),其中治疗组ESR下降水平较对照组差异具有统计学意义(P<0.05)。结论活性维生素D可以改善骨量减少的强直性脊柱炎患者的骨代谢指标并降低疾病活动度。
Objective To investigate the effect of active vitamin D on bone metabolism and disease activity in ankylosing spondylitis（AS） patients with low bone mineral density（BMD）. Methods Sixty AS patients with low BMD and 20 healthy controls were selected. Bone specific alkaline phosphatase（BALP）,tartrate resistant acid phosphatase-5 b（TRACP-5 b）,and 25-（OH） D3 were compared between the two groups. The 60 AS patients were randomly divided into the control group（30 cases） and the treatment group（30 cases）. The patients in the control group received meloxicam,sulfasalazine,and calcium carbonate. The patients in the treatment group received additional calcitriol. The serum levels of BALP,TRACP-5 b,and 25-（0 H） D3,BMD,erythrocyte sedimentation rate（ESR）,and C reactive protein（CRP） were compared between the two groups. Results The serum levels of BALP and TRACP-5 b in AS group were significant higher than those in healthy control group（P〈0. 05）,and the serum level of 25-（0 H） D3 was significant lower than that in healthy control group（P〈0. 05）. The serum levels of BALP and 25-（OH） D3 increased significantly bone in the control group and the treatment group（P〈0. 05）,while the serums levels of TRACP-5 b decreased（P〈0. 05）. The differences of BALP and 25-（OH） D3 before and after the treatment in treatment group were higher than those in the control group（P〈0. 05）. BMD of the lumbar spine,great trochanter,and intertrochanteric increased more significantly in treatment group than those in the control group after 6 months（P〈0. 05）,and BMD recovered to normal in 5 cases. The change of BMD in the control group was not obvious after the treatment（P〈0. 05）. The levels of ESR,CRP,andBASDAI scores decreased in both groups（P〈0. 05）. The decreased level of ESR score in the treatment group was more obvious than that in the control group（P〈0. 05）. Conclusion Active vitamin D improves the bone metabolism and reduce the disease activities
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2018年第3期324-327,344,共5页
Chinese Journal of Osteoporosis
基金
河北省卫生厅青年科技课题(20130527)
