Association Study In Bone Metabolism And Identify Classifications Of The Ankylosing Spondylitis Patients

Objective:Ankylosing Spondylitis(AS)is a kind of chronic spondyloarthritis,which majorly involves the axial joint especially the lumbar vertebra and the sacroiliac joints.Modern researches have shown that partial patients have decreased bone mass and abnormal bone metabolism,which means the increased risk of fracture.This paper builds itself upon three relationships.The first one is between the identify classifications and the Bone metabolism and Bone mineral density of AS patients.The second is between the identify classifications and the disease activity of AS patients.And the third is between the disease activity and the Bone metabolism and Bone mineral density of AS patients.This paper provides the basis for further combining traditional Chinese medicine with western medicine to preventive osteoporosis and reduce the risk of fractures.Methods:Accorded with the inclusive criteria,we collected 126 cases from the patients of inpatient and outpatient department of the Rheumatism Immunity in the PLA ARMY GENERAL Hospital from July 2016 to November.General information was recorded,which include sex,age and the course of disease.Using Dual Energy X-ray Absorptiometry,we measured the Bone mineral density and recorded the Z score of femoral neck and lumbarl-lumbar4.Depending on clinical laboratory of the PLA ARMY GENERAL Hospital,we measured and recorded Bone Gla Protein(BGP),Procollagen type Ⅰ N-terminal propeptide(PINP),Parathyroid Hormone(PTH),Serum Calcium(Ca),Alkaline Phosphatase(ALP),Erythrocyte Sedimentation Rate(ESR)and C-reactive Protein(CRP).We gathered the data about the disease activity and computed the disease activity score by the ASAS-endorsed disease activity score(ASDAS).According to "Clinical guideline of new drugs for traditional Chinese medicine(the newest)" we scientifically divided the AS patients into three types:the dampness-heat blockage syndrome,the cold-dampness syndrome,the stagnated blood syndrome,the asthenia of liver and kidney syndrome and the asthenia of kidney-YANG syndrome.With the help of SPSS 19.0,we analyzed the data about the identify classifications,the disease activity,and the Bone metabolism and mineral density,and mainly studied the correlation within the three above.Results:We collected 126 cases,in which male is 111 and female is 15.The ratio of man to female is 7.4 to 1.The number of patients with abnormal bone mass is 78,61.9%of the total.About the bone mineral density Z score of femoral neck and lumbarl-lumbar4:First,they were positive correlation with Ca;Second,there was no significant difference between the two and ALP or PTH(P>0.05);Third,there was no significant difference between the bone mineral density Z score of femoral neck and BGP(P>0.05),and the bone mineral density Z score of lumbar 1-lumbar4 was negative correlation with BGP and PINP;Fourth,they were negative correlation with CRP and ESR;Fifth,there was no significant difference the two and ASDAS-CRP or ASDAS-ESR(P>0.05).About the Bone mineral density and metabolism of the 5 traditional Chinese medicine syndromes:Compare with the other 3 syndromes,bone mass and Ca are lower,and PINP and BGP were higher in the asthenia of liver and kidney syndrome and the asthenia of kidney-YANG syndrome.About the disease activity and the inflammatory factors of the 5 traditional Chinese medicine syndromes:Compared with the other 4 syndromes,ERP and CRP were the highest in the asthenia of kidney-YANG syndrome.The stagnated blood syndrome was nuch active.Conclusion:First,this paper shows the AS patients whose bone mass was lower,also had lower Ca and higher BGP and PINP.And the higher BGP and PINP lead more positive osteogenesis.What is more,the link of the bone metabolism does not seem abnormal which ALP and PTH join.Besides,inflammatory mediators do have some influence about the osteoclasis,but the disease activity seems not.To reduce the bone mass,there should be some more factors that caused the osteoclasis,which strike the balance of the bone resorption and formation.Second,we can see from this paper,while the bone metabolism is more abnormal,the bone mass of the asthenia of liver and kidney syndrome and the asthenia of kidney-YANG syndrome is lower then the other three obviously.We should check the two kinds of patients clearly to control osteopenia and osteoporosis as early as possible.