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国际临床研究杂志

International Journal of Clinical Research

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International Journal of Clinical Research. 2025; 9: (9) ; 10.12208/j.ijcr.20250423 .

Study on influencing factors of osteoporosis in patients with ankylosing spondylitis
强直性脊柱炎患者骨质疏松的影响因素研究

作者： 王铭浩1, 王英南2, 赵蕾2, 陈艳红3, 岳静静1, 梁志强1 *

1 承德医学院附属医院风湿免疫科 河北承德

2 承德医学院附属医院教育处 河北承德

3 承德市中心医院神经内科 河北承德

*通讯作者： 梁志强,单位： 承德医学院附属医院风湿免疫科 河北承德；

引用本文: 王铭浩, 王英南, 赵蕾, 陈艳红, 岳静静, 梁志强 强直性脊柱炎患者骨质疏松的影响因素研究[J]. 国际临床研究杂志, 2025; 9: (9) : 46-49.
Published: 2025/9/21 11:10:47

摘要

目的 探讨强直性脊柱炎（AS）患者骨质疏松症与病程、年龄、性别、用药、炎症指标等因素的相关性，并进一步确定可能与强直性脊柱炎患者骨质疏松症相关的潜在因素，监测这些因素对疾病评估、预后、治疗的转归的临床意义。方法 回顾性研究我科2021年09月30日至2024年09月30日期间在我院就诊的148例强直性脊柱炎患者，其中男性患者118例，女性患者30例。收集了患者的性别、年龄、病程、骨密度（T-score）、红细胞沉降率（ESR）、C反应蛋白（CRP），以及治疗方案，包括传统合成DMARDs（柳氮磺吡啶、沙利度胺、甲氨蝶呤片）、生物制剂（肿瘤坏死因子抑制剂TNFi、白介素IL-17抑制剂）。应用多元线性回归分析、Pearson相关性分析以及Mann-Whitney U检验确定这些因素与AS患者T-score之间的关系。结果 骨密度与年龄和病程呈负相关（P<0.01）。血沉和C反应蛋白升高的AS患者的骨密度明显低于上述炎症指标较低或正常的AS患者（P<0.05）。应用生物制剂治疗相较应用传统合成DMARDs药物的患者，骨质疏松的风险降低。结论 性别、年龄、血沉、C反应蛋白与AS患者的骨质疏松有一定的负相关性，应用生物制剂治疗有可能改善骨质疏松情况，减低后续骨质疏松骨折的风险。

关键词： 强直性脊柱炎；骨质疏松；炎症指标；生物制剂

Abstract

Objective To explore the correlation between osteoporosis and factors such as disease duration, age, gender, medication, and inflammatory markers in patients with ankylosing spondylitis (AS). It further seeks to identify potential factors associated with osteoporosis in AS patients and to monitor the clinical significance of these factors for disease assessment, prognosis, and treatment outcomes.
Methods A retrospective study was conducted on 148 AS patients who visited our hospital between September 30, 2021, and September 30, 2024. Among them, 118 were male and 30 were female. Data were collected on patients' gender, age, disease duration, bone mineral density (T-score), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and treatment regimens, including traditional synthetic DMARDs (sulfasalazine, thalidomide, methotrexate tablets) and biologics (tumor necrosis factor inhibitors [TNFi], interleukin-17 inhibitors [IL-17]). Multivariate linear regression, Pearson correlation analysis, and Mann-Whitney U test were used to determine the relationship between these factors and the T-score in AS patients.
Results Bone mineral density was positively correlated with age and disease duration (P<0.01). AS patients with elevated ESR and CRP had significantly lower bone mineral density than those with lower or normal levels of these inflammatory markers (P<0.05). Compared with patients using traditional synthetic DMARDs, those receiving biologic treatment had a reduced risk of osteoporosis.
Conclusion   Gender, age, ESR, and CRP are positively correlated with osteoporosis in AS patients. The use of biologic therapy may improve osteoporosis and reduce the subsequent risk of osteoporotic fractures.

Key words： Ankylosing spondylitis; Osteoporosis; Inflammatory markers; Biologic therapy

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