来源：风湿病与关节炎,2023,12（6）:27-30.

早期类风湿关节炎的骨代谢特点（临床研究）

郑辉福，林凤耀，高德兴，苏禹榕，饶华春，许超尘

　　【摘　要】目的：研究早期类风湿关节炎患者血清中骨代谢指标的特点，探讨早期类风湿关节炎骨代谢的影响因素。方法：选取早期类风湿关节炎患者80例，健康对照组81例，观察2组骨代谢变化，以及β-胶原特殊序列与类风湿关节炎相关指标的相关性。结果：与对照组比较，早期类风湿关节炎组的Ⅰ型胶原氨基端延长肽、骨钙素、25-羟基维生素D含量显著降低，而β-胶原特殊序列含量升高，差异均有统计学意义（P < 0.05）。相关性分析中，β-胶原特殊序列与关节肿胀数、关节压痛数、C反应蛋白、红细胞沉降率、抗环瓜氨酸肽抗体（抗CCP抗体）呈正相关，与骨密度含量呈负相关。结论：早期类风湿关节炎患者的成骨细胞活性较健康对照者明显降低，破骨细胞活性明显增高，并且炎症及抗CCP抗体可影响破骨细胞的活性。

　　【关键词】　类风湿关节炎；早期；骨代谢；临床特点

The Characteristics of Bone Metabolism in Early Rheumatoid Arthritis

ZHENG Hui-fu,LIN Feng-yao,GAO De-xing,SU Yu-rong,RAO Hua-chun,XU Chao-chen

　　【ABSTRACT】Objective:To study the characteristics of bone metabolism indicators in serum of patients with early rheumatoid arthritis and explore the influencing factors in that stage.Methods:Eighty patients with early rheumatoid arthritis and 81 healthy controls were selected to observe changes in bone metabolism in both groups and find the correlation between β-Crosslaps and rheumatoid arthritis related indicators.Results:Compared with the control group,the content of typeⅠcollagen amino terminal extender peptide,osteocalcin,and 25-hydroxyvitamin D in the early rheumatoid arthritis group significantly reduced,while the content of β-Crosslaps increased,and the differences were statistically significant（P < 0.05）.In correlation analysis,β-Crosslaps was positively correlated with the number of joint swelling,joint tenderness,C-reactive protein,erythrocyte sedimentation rate,anti cyclic citrulline peptide antibody（anti CCP antibody）,and negatively correlated with bone mineral density.Conclusion:The activity of osteoblasts in patients with early rheumatoid arthritis is significantly lower than that in the healthy controls,and the activity of Osteoclast significantly increased.Inflammation and anti CCP antibodies can affect the activity of Osteoclast.

　　【Keywords】 rheumatoid arthritis;early stage;bone metabolism;clinical characteristics