骨代谢标志检测在骨质疏松、糖尿病、甲状腺功能亢进及类风湿性关节炎中的应用  

Determination of bone metabolism markers in patients with osteoporosis,diabetes mellitus,hyperthyroid and rheumatoid arthritis

作　　者：杨汝文[1] 张曼丽[1] 李雷[1] 姚小苓[1] 刘荣均[1] 郭燕云[1] 

机构地区：[1]昆明市中医医院,云南昆明650032

出　　处：《检验医学》2006年第4期355-357,共3页Laboratory Medicine

摘　　要：目的研究检测骨代谢标志在骨质疏松、糖尿病(DM)、甲状腺功能亢进(简称甲亢)及类风湿性关节炎(RA)临床诊断中的应用价值。方法检测89例骨质疏松患者,DM、甲亢及RA患者各50例和60名健康对照组血清中骨钙素(BGP)、骨特异性碱性磷酸酶(B-ALP)、Ⅰ型前胶原羧基端前肽(PICP)及尿中骨吸收指标尿脱氧吡啶酚(DPd)。结果骨质疏松男性患者组骨形成标志BGP、B-ALP、PICP明显低于健康对照组(P<0.01),而骨吸收指标DPd则明显高于健康对照组(P<0.01);绝经女性组BGP、B-ALP、PICP及DPd均明显高于健康对照组(P<0.01);未绝经女性组仅DPd明显高于健康对照组(P<0.01)。2型DM患者的BGP检测值明显低于健康对照组(P<0.01);而DPd则明显高于健康对照组,(P<0.01);B-ALP及PICP与健康组相比差异无显著性。RA患者DPd明显高于健康对照组(P<0.05)。甲亢患者BGP、B-ALP、PICP及DPd均高于健康对照组(P<0.01)。结论检测骨代谢标志在上述4种疾病中可早期发现骨代谢紊乱,其中男性骨质疏松及RA患者均以骨吸收改变为主,而绝经后女性骨质疏松及甲亢患者又以骨丢失为主。4项标志的组合检测能反映骨代谢的整体状况,如仅用一项标志易漏诊误诊。Objective To study the value of bone metabolism markers in the diagnosis of osteoporosis, diabetes mellitus（DM）, hyperthyroid and rheumatoid arthritis（RA）. Methods Serum bone gla-protein（BGP）, bone-specific alkaline phosphatase（B-ALP） ,carboxyterminal crosslinked propeptide of type I procollagen （PICP） and urine deoxypridinoline（DPd） were measured in 89 cases of osteoporosis, 50 cases each of DM, hyperthyroid and RA, and 60 healthy controls. Results Compare with healthy control： In osteoporotic group, the osteosis indicators BGP, B-ALP,and PICP were significantly lower（P 〈 0.01 ）. The osteolytie indictor DPd was significantly higher （ P 〈 0.01 ）. In menopausal group, BGP, B-ALP, PICP and DPd were generally higher （P 〈0.01 ）, in non-menopausal group , only DPd was significantly higher （P 〈0. 01 ）. In 2 type DM, BGP was lower while DPd was higher （P 〈0. 01 ）. There was no obvious difference in B-ALP and PICP compare with healthy control （P 〈 0.05）. In RA group, DPd was higher （P 〈 0.05）. In hyperthyroid group, BGP,B-ALP, PICP and DPd were generally higher （P 〈 0.01 ）. Conclusions Bone metabolism disord in above mentioned diseases can be find early by measurement of bone metabolism markers. Male osteoporosis and RA are characterized by osteolytic disorder. Female osteoporosis and hyperthyroid are characterized bybone loss with active bone metabolism. The whole condition of bone metabolism can be reflected by combined measurement of the four markers.

关 键 词：骨钙素 骨特异性碱性磷酸酶 I型前胶原羧基端前肽 尿脱氧吡啶酚 骨质疏松 糖尿病 甲状腺功 能亢进 类风湿性关节炎 

分 类 号：R446.1[医药卫生—诊断学]