基于组织切片的类风湿性关节炎与骨性关节炎骨质量的对比研究

摘要

目的 骨质量是用来评价骨质条件的新概念,是影响人工膝关节使用寿命的影响因素之一,评价患者的骨质量参数对临床治疗有一定的指导意义.比较膝关节类风湿性关节炎(rheumatoid arthritis,RA)和骨性关节炎(osteoarthritis,OA)患者的骨质量的差异,以指导临床人工全膝关节置换(total knee replacement,TKP)的治疗.方法 收集人工TKP术中截取的RA及OA患者的松质骨作组织切片检查,行2种标本的骨小梁形态的结构参数计量分析.结果 组织切片下膝关节OA的骨小梁参数如骨小梁的面积体积比(bone surface/bone volumn ratio,BS/BV%)、骨小梁的厚度(trabecular thickness,Tb.Th)、骨小梁的结点数(trabecular node number,Tb.n)与RA相比,具有显著性差异(P＜0.01).结论 膝关节OA患者的骨质量优于RA患者.%Objective Bone quality is a new concept to evaluate the strength of human bone. It is one of the factors that determine the lifetime of artificial knee joint. The aim of this study is to compare the bone quality of theumatoid arthritis with the hone quality of osteoarthritis. Methods The samples of the spongy bone of the patients with theumatoid arthritis and the spongy bone of the patients with osteoarthritis were collected. We analyzed the bone samples by histomorphomertry and calculated the trabecular bone surface/bone volume ratio ( BS/BV％ ) , trabecular thickneas (Tb, Th) and trabecular node number ( Tb. n) . Results There were significant differences of BS/BV％ , Tb. Th and Tb. n between theumatoid arthritis and osteoarthritis (P ＜ 0. 01). Conclusion The bone quality of the patients with osteoarthritis is superior to the bone quality of the patients with theumatoid arthritis.