Application Value Of Quantitative CT In The Efficacy Of Echnetium⁹⁹Tc Methylene Diphosphonate On Osteoporosis In Rheumatoid Arthritis Patients

objective To investigate the value of QCT in the the efficacy of ⁹⁹Tc-MDP on osteoporosis in RA patients.Methods Sixty RA with osteoporosis patients were randomly divided into two groups:one group was administered with MTX,the other group was administered with MTX and⁹⁹Tc-MDP.Thirty patients with primary osteoporosis（OP）were treated with ⁹⁹Tc-MDP.The serum levels of tumor necrosis factor-α（TNF-α）,Interleukinin-1（IL-1）and Interleukinin-1（IL-17）were detected by enzyme-linked immunosorbent assay（ELISA）.The serum levels ofβ-Crosslaps（β-CTX）,Total Procollagen Type IN Propeptide（TPINP）,25-hydroxyvitamin D（25-OH-VD）,Osteocalcin（BGP）and Parathyroid Hormone（PTH）were detected by electrochemical photoluminescence method.Serum inflammatory factors,bone turnover markers,VAS pain score,DAS28 score,the bone mineral density（BMD）measured by DXA and QCT were determined before and after the treatment.FRAX was used to calculate the 10-year probability of a major osteoporotic fracture（PMOF）in RA patients.Results1.After treatment,DAS28 score and VAS pain score on osteoporosis in RA patients administered with MTX and ⁹⁹Tc-MDP were significantly decreased than that administered with MTX,the difference were statistically significant（P<0.05）.2.After treatment,the serum level ofβ-CTX on osteoporosis in RA patients administered with MTX and ⁹⁹Tc-MDP was significant difference than that administered with MTX,with statistical significance（P<0.05）.After treatment,the serum level ofβ-CTX on OP patients administered with ⁹⁹Tc-MDP was significant difference than that before treatment,with statistical significance（P<0.05）.3.After treatment,the BMD measured by QCT on osteoporosis in RA patients administered with MTX and ⁹⁹Tc-MDP was higher than that administered with MTX,with statistical significance（P<0.05）.But there was no significant difference in BMD measured by DXA between the two groups（P>0.05）.After treatment,the BMD measured by QCT on OP patients administered with ⁹⁹Tc-MDP was significant difference than that before treatment,with statistical significance（P<0.05）.But there was no significant difference in BMD measured by DXA before and after the treatment（P>0.05）.4.There was negative correlation between the BMD measured by QCT and the serum level ofβ-CTX（r=-0.339,P<0.05）.5.There was no significant difference in the 10-year PMOF calculated by DXA and QCT（P>0.05）.Conclusion1.MTX combined with ⁹⁹Tc-MDP can improve the disease activity and osteoporosis of rheumatoid arthritis.2.The BMD measured by QCT can be observed in the early stage in the treatment of osteoporosis in RA patients,and the BMD measured by QCT was correlated with the serum level ofβ-CTX.