成年女性血骨转换指标变化的临床观察  

Clinical observation on changes of serum bone turnover indicators of adult females

作　　者：叶竹[1] 刘坚[1] 王应立[1] 韩炜[1] 杨健[1] 邓伟民[1] 

机构地区：[1]中国人民解放军广州军区广州总医院华侨高级医疗中心,广东省广州市510010

出　　处：《实用老年医学》2012年第5期421-425,共5页Practical Geriatrics

基　　金：2010年度军队中医药科研专项课题重点项目(10ZYZ115);广东省科学技术厅-广东省中医药科学院联合科研专项(2011B032200005)

摘　　要：目的分析40～80岁女性血清中总Ⅰ型胶原氨基端前肽(PINP)、β-胶原降解产物(β-Cross-laps)、N端骨钙素(N-MID)及甲状旁腺素(PTH)的变化规律,以及这几项指标与骨密度(BMD)的相关性。方法采用美国GE公司生产的LunarProdigy双能X线(DXA)骨密度仪,检测各部位BMD;采用电化学发光免疫分析法分析血清中PINP、β-Crosslaps、N-MID及PTH的含量。结果 PINP、β-Crosslaps及N-MID在50～59岁年龄段开始明显升高(P<0.05),随后随年龄增长呈下降趋势;PTH在70～80年龄段开始明显升高(P<0.05)。PINP、β-Crosslaps及N-MID与各部位BMD呈显著负相关(r=-0.256～-0.134,P均<0.05);PTH与FN及Troch的BMD呈显著负相关(r=-0.138、-0.201,P均<0.05)。与正常骨量组比较,低骨量组(除Ward's部位外)和骨质疏松(OP)组妇女的PINP及N-MID显著升高(P均<0.05);低骨量组和OP组妇女的β-Crosslaps均显著升高(P<0.05);在L1～4及FN区域,低骨量组妇女的PTH显著升高(P均<0.05),在FN、Ward及Troch区域,OP组妇女的PTH显著升高(P均<0.05)。结论高骨转换状态是女性骨量丢失的重要原因,而PINP、β-Crosslaps、N-MID及PTH能反映女性随年龄和绝经变化的骨转换状态,监测这几个指标有助于早期防治OP。Objective To analyze the changes of serum procollagen type Ⅰ intact N-terminal propeptide（PINP）,β-Crosslaps,N-MID osteocalcin（N-MID） and parathyroid hormone（PTH） of 40-80 years old women,as well as their correlations with bone mineral density（BMD）.Methods The levels of PINP,β-Crosslaps,N-MID and PTH were measured by electrochemiluminescence immunoassay;BMD was measured by American GE company＇s Lunar Prodigy dual energy X ray（DXA） bone density meter.Results Serum PINP,β-Crosslaps and N-MID of the 50-59 group increased significantly（P0.05）,followed by slight falls;and PTH increased significantly in the 70-80 group（P0.05）.PINP,β-Crosslaps and N-MID was negatively correlated with BMD of all parts（r=-0.256^-0.134,P0.05）;and PTH was negatively correlated with BMD of FN and Troch（r=-0.138,-0.201,P0.05）.Compared with normal group,PINP and N-MID of both low bone mass（except Ward＇s）and osteoporosis groups were significantly higher（P0.05）;β-Crosslaps of both low bone mass and osteoporosis groups were significantly higher（P0.05）.At L1-4and FN,PTH of the low bone mass group was significantly higher（P0.05）,and at FN,Ward and Troch,PTH of osteoporosis group was all significantly increased（P0.05）.Conclusions High bone turnover is an important cause of bone loss in women,and PINP,β-Crosslaps,N-MID and PTH are sensitive and specific bone biochemical markers which are indicators of the bone turnover change with age in women.Monitoring these indicators will help to prevent and treat osteoporosis earlier.

关 键 词：总Ⅰ型胶原氨基端前肽 β-胶原降解产物 N端骨钙素 甲状旁腺素 骨密度 

分 类 号：R580[医药卫生—内分泌]