The Clinical Study On The Osteoporosis Of Rheumatoid Arthritis Patients

Objective To study on the changes in bone mineral density(BMD) and the prevalence of osteoporosis(OP) in patients with rheumatoid arthritis(RA),and the effects of related clinical factors. Methods 105RA patients'spine and femur BMDs were measured by X-ray absorptiometry, and the clinical factors, such as functional status, X-ray status, the number of tender or swollen joints, C-reactive protein(CRP)?anti- streptolysin"O"test(ASO)?rheumatoid factor(RF)?erythrocyte sedimentation rate(ESR)? cyclic citrullinated peptides(CCP) ? calcium(Ca),phosphorus(P), and alkaline phosphatase (AKP), were also measured the meantime.Results: The incident rates of normal BMD, low BM and osteoporosis are 23%,30%,47% respectively in 105 RA patients, which indicate the significant low BM in RA patients; there are significant differences in OP and non-OP group in terms of age (P<0.001),course of disease(p<0.01),ESR (p<0.05),Ca (p<0.05),AKP (p<0.01),join function(p<0.05),and there are no significant differences on the number joint tenderness, swollen joint and RF?CRP ?CCP?P?ASO?X-ray staging in RA patients. There is significant difference in the incident rates(X2 =11.021,OR=4.189, P=0.001), spine and femur BMDs(p<0.01) of glucocorticoid and non- glucocorticoid groups of RA patients. The incident rate of OP in small-dosed- glucocorticoid group is higher than non-small-dosed- glucocorticoid group(p<0.01), long-term group is higher than short-term group(p<0.01).There is no significant differences in immunosuppressant- group and non-immunosuppressant-group in terms of OP(X2 =0.536 OR=1.333, P=0.464). Conclusion Multi-location BM lost and osteoporosis are more pronounced in RA patients, and there is correlation relationship with patient's history, ESR, calcium, phosphorus(P), and alkaline phosphatase(AKP),and glucocorticoid administration,and there is no significant relationship with immunosuppressant administration. In out study , we suggest that, the diagnosis of RA should be combined with BMD testing, in order to come out with BMC,and osteoporosis should be early detected and early prevent during the treatment of RA patients.