| 摘要: |
| 目的 比较酒精性肝硬化患者、乙肝肝硬化患者和健康对照者之间骨密度的差异。方法 采用双能X线骨密度测定法，测定57例酒精性肝硬化患者、67例乙肝肝硬化患者和175例健康者对照者的腰椎（L1~L4）和双侧髋关节的骨密度值，同时采集研究对象的年龄、性别、肝纤维化及肝脏功能等指标。组间差异采用独立样本t检验；骨密度影响因素采用logistic回归分析。结果 酒精性肝硬化和乙肝肝硬化患者组的腰椎和髋关节骨密度值均低于健康对照组（P<0.05）；酒精性肝硬化患者组的腰椎和髋关节骨密度值低于乙肝肝硬化患者组（P<0.05）。除乙肝病毒感染和酒精性病因外，单因素分析发现性别、肝纤维化程度及肝功能等都和研究对象的腰椎和髋关节骨密度值相关（P<0.01）。进一步多因素logistic回归发现，乙肝肝硬化（OR=1.521，95%CI：1.342～2.354） 和酒精性肝硬化（OR=2.053，95%CI：1.931～3.852）是患者骨密度降低的独立危险因素。结论 肝硬化（包括酒精性和乙肝性）患者的骨密度低于健康对照组，是骨质疏松的独立危险因素。 |
| 关键词: 双能X线骨密度仪 骨密度 酒精性肝硬化 乙型肝炎 |
| DOI：10.3724/SP.J.1008.2014.00535 |
| 投稿时间：2013-11-14修订日期：2014-03-20 |
| 基金项目: |
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| Bone mineral density assessed by dual energy X-ray radiography in patients with alcoholic or HBV-related liver cirrhosis |
| XU Mei-juan,ZHANG Lan-ling,SHI Ye-qing,PANG Ya-fei,ZHAO Dong-bao* |
(Department of Rheumatism, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding authors.) |
| Abstract: |
| Objective To investigate the differences of bone mineral density (BMD) among the patients with alcoholic or HBV-related liver cirrhosis, and healthy controls. Methods Dual-energy X-ray radiography was employed to determine the BMD of he lumbar vertebra and bilateral hip joints in 57 patients with alcoholic cirrhosis, 67 with hepatitis B cirrhosis, and 175 healthy controls. The demographic data and clinical characteristics(hepatic fibrosis and hepatic function) of all the participants were collected. Independent sample t-test was used to compare the differences among 3 groups and multiple classified logistical regression analysis was used to evaluate factors influencing BMD. Results The BMD of alcoholic cirrhosis and HBV-related cirrhosis patients were significantly lower than that of healthy controls(P<0.01), and the BMD in alcohol cirrhosis patients was significantly lower than that in HBV-related cirrhosis patients(P<0.05). Univariate logistic regression analysis identified that female gender, elder age, liver cirrhosis degree, and liver function were significantly correlated with the levels of BMD(P<0.01). Multivariate analysis showed that alcoholic cirrhosis (OR=2.053, 95%CI=1.931-3.852) and HBV-related cirrhosis (OR=1.521, 95%CI=1.342-2.354) were the independent risks of reduced BMD in patients. Conclusion BMD levels of patients with alcoholic cirrhosis and HBV-related cirrhosis are significantly lower than that of the healthy controls, and hepatic cirrhosis is independent factor of osteoporosis. |
| Key words: dual-energy X-ray absorptiometry bone density alcoholic liver cirrhosis hepatitis B |
