强直性脊柱炎患者血清TNF-a、BGP和CTX水平与骨密度的关系  

The relationship between the level of serum TNF-a,BGP,CTX and BMD in patients with ankylosing spondylitis

作　　者：许敬人[1] 房敏[2] 韩捷[1] 林研[1] 许淑敏[1] 孙勤[1] 

机构地区：[1]同济大学附属东方医院,上海200120 [2]上海中医药大学附属中西医结合岳阳医院,200437

出　　处：《颈腰痛杂志》2006年第3期170-172,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨强直性脊柱炎(AS)患者骨质疏松(OP)的发病机制。方法分别测定36例男性AS患者血清肿瘤坏死因子-a(TNF-a)、骨钙素(BGP)I、-型胶原C末端肽(CTX)水平及腰椎和股骨颈的骨密度(BMD)值,并与20例健康者对照。结果AS早期腰椎和股骨颈BMD均低于对照组,晚期股骨颈BMD更低于对照组。AS血清TNF-a、CTX水平较对照组显著增高(P<0.01;P<0.05),而血清BGP水平较对照组无显著差差异(P>0.05)。AS患者中OP组TNF-a、CTX水平较NOP组显著增高(P<0.01;P<0.05),OP组中血清TNF-a与CTX呈正相关,与股骨颈密度呈负相关;与BGP无明显相关性。结论AS患者主要是由于骨吸收增加而导致骨质疏松的发生。血清TNF-α水平的增高可促进骨吸收加强,是AS骨质疏松的重要原因之一。降低血清TNF-a水平,对AS患者骨质疏松的防治可能有积极的意义。Objective To discuss the pathogenesis of osteporosis（OP）in patients with ankylosing spondylitis （AS）. Methods The level of serum tumor necrosis factor-a （TNF-a）,bona Gla protain （BGP）,C-terminal teiopeptides of type l collagen （Crosslaps, CTX）and bone GLa protein （BGP）, C- terminal telopeptides of type I collagen （Crosslaps,CYX）and bone mineral density （BMD）at lumbar and femoral neck were measured in 36 male AS in patients with ankylosing spindylitis ,and 20 age-matched healthy controls. Results In the early stage of AS,The patients had lower volume of BMD in both femoral neck and lumbar than controls. Even the BMD of femoral neck was still lower that of healthy controls in the late stage. Serum TNF-a and CTX in AS increased more than those of controls （P〈0.01;P〈0.05）,and BGP levels had no difference between AS and controls （P〉 0.05）.The level of Serum TNF-a and CTX in osteoporosis （OP）gruup were much higher than those in non-osteoporosis（NOP）group（P〈0.01 ;P〈0.05 ）.In the OP group of AS, serum TNF-a had posituve correlationship with CTX,and negative correlationship with BMD of femoral neck.No correlation was found between TNF-a and BGP. Conclusions Bone resorption is strengthened in patients with AS,which lead to osteopoeosis （OP）.Elevation of serum TNF-a can accelerate bone resorption and cause OP .Reducing the level of serum TNF-a may be very important for prevention and treatment of OP in patients with AS.

关 键 词：强直性脊柱炎 骨密度 肿瘤坏死因了-a 骨钙素 I-型胶原C末端肽 

分 类 号：R593.23[医药卫生—内科学]