脊柱关节炎患者骨质疏松的诊断现状

脊柱关节炎是一类以累及脊柱和外周关节,或者关节、韧带和肌腱为主要表现的慢性炎症性风湿病的总称,主要临床症状为炎性背痛、不对称的周围性寡关节炎、起止点炎,以及某些器官损害如前葡萄膜炎、银屑病和慢性炎症性肠病。骨质疏松及低骨量在脊柱关节炎患者中普遍存在,是脊柱关节炎最常见的并发症。目前骨密度的主要检测方法包括双能X线吸收法（DXA）、跟骨超声、定量计算机断层扫描（QCT）等,常见的检测部位有腰椎前后位、腰椎侧位、股骨颈、髋区、前臂等,但各检测方法、检测部位测得的骨密度值及骨质疏松发病率有很大差异。定量CT是检测脊柱关节炎患者骨质疏松最为准确的方法,而腰椎侧位和股骨颈DXA则是目前国内检测脊柱关节炎...

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Bibliographic Details
Published in中国骨质疏松杂志 Vol. 23; no. 2; pp. 277 - 280
Main Author 刘佳滟 薛愉 万伟国 刘从进
Format Journal Article
LanguageChinese
Published 复旦大学附属华山医院风湿科,上海,200040%复旦大学附属华山医院核医学科,上海,200040 2017
Subjects
强直性脊柱炎
脊柱关节炎
诊断
银屑病关节炎
骨质疏松
骨质疏松
Osteoporosis
诊断
银屑病关节炎
强直性脊柱炎
Spondyloarthritis
Diagnose
脊柱关节炎
Ankylosing spondylitis
Psoriatic arthritis
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ISSN1006-7108
DOI10.3969/j.issn.1006-7108.2017.02.029

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Summary:脊柱关节炎是一类以累及脊柱和外周关节,或者关节、韧带和肌腱为主要表现的慢性炎症性风湿病的总称,主要临床症状为炎性背痛、不对称的周围性寡关节炎、起止点炎,以及某些器官损害如前葡萄膜炎、银屑病和慢性炎症性肠病。骨质疏松及低骨量在脊柱关节炎患者中普遍存在,是脊柱关节炎最常见的并发症。目前骨密度的主要检测方法包括双能X线吸收法（DXA）、跟骨超声、定量计算机断层扫描（QCT）等,常见的检测部位有腰椎前后位、腰椎侧位、股骨颈、髋区、前臂等,但各检测方法、检测部位测得的骨密度值及骨质疏松发病率有很大差异。定量CT是检测脊柱关节炎患者骨质疏松最为准确的方法,而腰椎侧位和股骨颈DXA则是目前国内检测脊柱关节炎患者骨质疏松最广泛和有效的方法。脊柱关节炎各分型中强直性脊柱炎患者的骨质疏松患病率高于银屑病关节炎。且骨质疏松患病率可能随病程的延长而升高。对于继发骨质疏松的治疗,除双膦酸盐等常规治疗药物,针对脊柱关节炎的TNF-α抑制剂亦有一定疗效。
Bibliography:LIU Jiayan1, XUE Yu1, WAN Weiguo1, LIU Congjin2（1. Department of Rheumatology, Hnashan Hospital Affiliated Fudan Univesity, Shanghai 200040, China 2. Department of Nuclear Medicine, Huashan Hospital Affiliated Fudan University, Shanghai 200040, China）
Spondyloarthritis（SpA） is a family of chronic inflammatory rheumatic disease.Clinical features of this group include inflammatory back pain,asymmetrical peripheral oligoarthritis,enthesitis,and specific organ involvement such as anterior uveitis,psoriasis,and chronic inflammatory bowel disease.Osteoporosis or osteopenia is common in SpA,and is the most frequent complication.Currently,bone mineral density is evaluated mostly by using quantitative computed tomography（QCT）,quantitative ultrasound,or dual-energy X-ray absorptiometry（DXA）.The prevalence varies according to the detection site.QCT is the most accurate measurement,while DXA at lateral spine and femoral neck is more available in China.Osteoporosis is more common in ankylosing spondylitis than in psoriatic
ISSN:1006-7108
DOI:10.3969/j.issn.1006-7108.2017.02.029