活性维生素D 对骨量减少的强直性脊柱炎患者骨代谢指标及病情的影响.

Objective To investigate the effect of active vitamin D on bone metabolism and disease activity in ankylosing spondylitis ( AS) patients with low bone mineral density ( BMD) ． Methods Sixty AS patients with low BMD and 20 healthy controls were selected． Bone specific alkaline phosphatase ( BALP) ，tartrate resistant acid phosphatase-5b ( TＲACP-5b) ，and 25-( OH) D3 were compared between the two groups． The 60 AS patients were randomly divided into the control group ( 30 cases) and the treatment group ( 30 cases) ． The patients in the control group received meloxicam，sulfasalazine，and calcium carbonate． The patients in the treatment group received additional calcitriol． The serum levels of BALP，TＲACP-5b，and 25-( 0H) D3，BMD，erythrocyte sedimentation rate ( ESＲ)，and C reactive protein ( CＲP) were compared between the two groups． Ｒesults The serum levels of BALP and TＲACP-5b in AS group were significant higher than those in healthy control group (P ＜ 0.05) ，and the serum level of 25-( 0H) D3 was significant lower than that in healthy control group (P ＜ 0.05)． The serum levels of BALP and 25-( OH) D3 increased significantly bone in the control group and the treatment group (P ＜ 0.05) ，while the serums levels of TＲACP-5b decreased ( P ＜ 0.05)． The differences of BALP and 25-( OH) D3 before and after the treatment in treatment group were higher than those in the control group (P ＜ 0.05)． BMD of the lumbar spine，great trochanter，and intertrochanteric increased more significantly in treatment group than those in the control group after 6 months (P ＜ 0.05)，and BMD recovered to normal in 5 cases． The change of BMD in the control group was not obvious after the treatment (P ＜ 0.05)． The levels of ESＲ，CＲP，and BASDAI scores decreased in both groups ( P ＜ 0. 05) ． The decreased level of ESＲ score in the treatment group was more obvious than that in the control group ( P ＜ 0. 05) ． Conclusion Active vitamin D improves the bone metabolism and reduce the disease activities in AS patients with low bone mineral density． [ABSTRACT FROM AUTHOR]