Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography
Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography
复制标题
通过高分辨率外周定量计算机断层扫描评估原发性肥厚性骨关节病患者远端指间关节骨微结构受损
DOI：
10.1007/s00198-019-05168-3
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发表时间：
2019-10-23
影响因子：
4
通讯作者：
Qin, L.
中科院分区：
文献类型：
--
作者：
Pang, Q.;Xu, Y.;Qin, L.
本研究旨在应用HR-pQCT研究PHO患者手指关节的骨损害情况。结果显示，根据HR-pQCT评估，PHO患者和健康对照组在DIP时的骨结构和生物力学参数有显著差异。此外，血清PGE2、hsCRP和ESR水平与总vBMD呈负相关。本研究旨在首次应用高分辨率外周定量计算机断层扫描(HR-pQCT)检测原发性肥厚性骨关节病(Pho)患者手指关节骨损伤情况。对PHO患者和对照组的手部远端指间关节(DIP)的骨侵蚀进行了X射线检查。同时采用HR-pQCT测量第3次时的骨几何参数、vBMD、微结构参数和个体骨质侵蚀的大小。结果与X线相比，HR-pQCT对骨质侵蚀的诊断更为敏感，在第3次低位时HR-pQCT检查有14例PHO患者，而X线片为10例。平均侵蚀深度为1.38±0.80 mm，平均宽度为0.79±0.27 mm，平均体积为1.71±0.52mm3。在第3次浸泡的确定感兴趣区，骨的横截面积，包括总面积(+25.3%，p≤0.05)、骨小梁面积(+56.2%，p≤0.05)和皮质周长(+10.7%，p≤0.05)显著大于对照组。PHO患者的总vBMD比对照组低11.9%(p≤0.05)。生化检测结果显示PHO患者炎性细胞因子、骨吸收标志物和关节退变标志物水平升高。血清前列腺素PGE2、超敏C反应蛋白(HsCRP)和血沉(ESR)水平与总vBMD呈负相关。结论本研究通过显示PHO患者和健康对照组在DISP时的结构和生物力学参数的差异，显示了DISP时HR-pQCT测量的敏感性，这对了解PHO患者的骨恶化具有临床意义。
SummaryThis study aimed to investigate the bone impairment in finger joints in PHO patients by HR-pQCT. Results showed distinguished differences in bone architecture and biomechanics parameters at DIPs between PHO patients and healthy controls using HR-pQCT assessment. Besides, serum PGE2, hsCRP and ESR levels were found negatively correlated with total vBMD.IntroductionThis study aimed to investigate the bone impairment in finger joints in primary hypertrophic osteoarthropathy (PHO) patients firstly by high-resolution peripheral quantitative computed tomography (HR-pQCT).MethodsFifteen PHO patients and 15 healthy controls were enrolled in this study. Bone erosions in hands at distal interphalangeal joints (DIPs) in both PHO patients and controls were evaluated by X-ray. Bone geometry, vBMD, microstructure parameters, and size of individual bone erosion were also measured at the 3rd DIP by HR-pQCT as well. Blood biochemistry levels between the two groups were also compared.ResultsCompared to X-ray, HR-pQCT assessment were more sensitive for detection of bone erosions, with 14 PHO patients by HR-pQCT versus ten PHO patients by X-ray judged at the 3rd DIP. The average depth, width, and volume of erosions size in PHO patients were 1.38 ± 0.80 mm, 0.79 ± 0.27 mm, and 1.71 ± 0.52 mm3, respectively. The bone cross-areas including total area (+ 25.3%,p≤ 0.05), trabecular area (+ 56.2%,p≤ 0.05), and cortical perimeter (+ 10.7%,p≤ 0.05) at the defined region of interest of 3rd DIP was significantly larger than controls. Total vBMD was 11.9% lower in PHO patients compared with the controls (p≤ 0.05). Biochemical test results showed the increased levels of inflammatory cytokines, bone resorption markers, and joint degeneration markers in PHO patients. Serum prostaglandin PGE2, high-sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) levels were found negatively correlated with total vBMD.ConclusionsThis study demonstrated higher sensitivity of the HR-pQCT measurement at DIPs by showing the differences in architecture and biomechanics parameters at DIPs between the PHO patients and healthy controls, which would be of interest clinically to investigate bone deterioration in PHO patients.