老年原发性骨质疏松患者骨密度、骨代谢的生化指标和骨质疏松性骨折关系的研究  

The study of the relationships among bone mineral density,bone biochemical markers,and osteoporotic fractures in senior patients with primary osteoporosis

作　　者：张冬梅[1] 冯波[1] 倪亚芳[1] 孙勤[1] 

机构地区：[1]同济大学附属东方医院内分泌科,上海200120

出　　处：《中国骨质疏松杂志》2011年第4期304-306,共3页Chinese Journal of Osteoporosis

基　　金：民政部"十一五"期间老年医学骨质疏松项目[(2008)47-1-42]

摘　　要：目的研究和探讨反映骨形成的生化指标骨钙素N端中分子片段(N-MID)和反映骨吸收的生化指标β-胶原降解产物(β-CTX)以及25羟维生素D(25OHD)与骨密度和骨质疏松性骨折的关系。方法采用双能X线骨密度仪美国Lunar DPXIQ No.5689骨密度仪测定腰椎(L1-4)骨密度(BMD),采用电化学发光法(ECLIA)测定N-MID和β-CTX,采用酶联免疫法(ELISA)测定25OHD,对87例患者进行上述指标测定并按骨密度正常、骨质疏松和骨质疏松伴有骨折随机分为A组、B组和C组,应用SPSS13.0分析软件进行统计学分析。结果 B组和C组骨密度较A组骨密度下降,并有统计学差异(P<0.05,P<0.01),C组骨密度较B组骨密度下降,但无统计学意义(P>0.05)BMI C组较A组降低,并有统计学差异(P<0.05),25OHD和反映骨形成的生化指标骨钙素N端中分子片段(N-MID)B组和C组低于A组,并有统计学差异(P<0.05,P<0.05),C组较B组下降有统计学意义(P<0.05)反映骨吸收的生化指标β-胶原降解产物(β-CTX)B组和C组高于A组,并有统计学差异(P<0.05和P<0.01),C组高于B组并有统计学差异(P<0.05);骨密度与β-CTX呈负相关,与BMI、25OHD、N-MID呈正相关。结论骨代谢的生化指标更能早期反映骨代谢的变化,与骨密度联合判断骨骼的状态更加全面。对于判断老年骨质疏松患者的骨代谢状态,预测骨折危险有着重要的意义。Objective To study and explore the relationships among the middle molecular weight segment of N-terminal of osteoealein （N-MID） that reflects bone formation, the β-collagen degradation product （β- CTX） that reflects bone resorption, 25-hydroxivatamin D （25 OHD） , and bone mineral density （BMD） and osteoporotic fracture. Methods BMDs at L1-4 sites were measured using dual-energy X-ray ahsorptiometry （Lunar DPXIQ No. 5689 ）. N-MID and β-CTX were determined using electrochemiluminescence immunoassay （ECLIA）. 25OHD was determined using ELISA methods. Eighty-seven patients were examined using above methods and they were randomly divided into normal BMD group （ Group A） , osteoporosis group （ Group B）, and osteoporosis with fracture group （ Group C）. Statistical analysis was performed using SPSS 13.0 software. Results BMD was significantly lower in Group B and C than that in Group A （P 〈0.05, P 〈0.01）. BMD was lower in Group C than that in B group, with no statistical significance （P 〉0.05）. BMI was significantly lower in Group C than that in Group B （P 〈0.05）. 25OHD and N-MID that reflects bone formation were significantly lower in Group B and C than those in Group A （P 〈0.05, P 〈0.05）. 25OHD and N-MID were significantly lower in Group C than those in Group B （P 〈 0.05）. β-CTX that reflects bone resorption was significantly higher in Group B and C than that in Group A （P 〈0.05, P 〈0. 01 ）. β-CTX was significantly higher in Group C than that in Group B （P 〈0. 05）. The BMD was negatively correlated with β-CTX, and positively correlated with N-MID, 25OHD, and BMI. Conclusion The biochemical markers reflect bone metabolic status earlier than BMD does. The combination of BMD and biochemical markers reflects bone status more comprehensively. It is of important significance for evaluating bone metabolic status in senior osteoporosis patients and for predicting the osteoporotic fracture.

关 键 词：骨密度 骨代谢的生化指标 骨质疏松性骨折 

分 类 号：R681[医药卫生—骨科学]