抗酒石酸酸性磷酸酶5bI型胶原C端肽骨特异性碱性磷酸酶在银屑病关节炎骨质破坏中的意义  

The effects of tartrate-resistant acid phosphatase 5b, C-terminal telopeptide of collagen- I , bone alkaline phosphatase as bone metabolism markers on the bone destructions of psoriatic arthritis

作　　者：程青青[1] 万伟国[1] 黄琼[2] 薛愉[1] 姜莉[1] 邹和建[1] 

机构地区：[1]复旦大学附属华山医院风湿免疫科,上海200040 [2]复旦大学附属华山医院皮肤科,上海200040

出　　处：《中华风湿病学杂志》2013年第5期303-306,共4页Chinese Journal of Rheumatology

摘　　要：目的观察银屑病关节炎患者骨代谢情况，探讨血清骨代谢标记物抗酒石酸酸性磷酸酶5b（TRACPSb）、I型胶原C端肽（CTX-I）、骨特异性碱性磷酸酶（BALP）在银屑病关节炎（VsA）骨质破坏中的意义。方法选择PsA患者65例，银屑病患者30例，健康志愿者30名。采用双能x线法（DXA）检测PsA患者腰椎及左股骨颈部位的骨密度，采用酶联免疫吸附试验（EHSA）法检测并比较各组血清骨代谢标记物TRACPSb、CTX-I、BALP水平。根据影像学资料有无骨质破坏将PsA患者分为骨质破坏组和非骨质破坏组，分别比较2组患者血清骨代谢标记物水平、P8A关节活动度指数的水平。采用Mann．Whitney秩和检验或r检验进行统计学分析。结果健康对照组、银屑病组、PsA组血清TRACP5b水平分别为（O．9±0．4）、（0．7±0．5）、（2．0±1．4）U／L，PsA组TRACPSb水平明显高于健康对照组和银屑病组（z值分别为-3．698，-3．638；P〈0．05）。3组血清CTX-I水平分别为（0．9±0．8）、（0．6±0．7）、（2．6±1．8）ng／ml，PsA组CTX-I水平明显高于健康对照组和银屑病组（z值分别为-5．262，-5．734；P〈0．05）。3组血清BALP水平分别为（22±4）、（22±4）、（25＋7）U／L，PsA组BALP水平高于健康对照组和银屑病组（z值分别为-2．214，-2．000；P〈0．05）。骨质破坏组患者骨吸收标记物TRACP5b[（2．6±1．4）U／L]、CTX-I[（3．1±1．8）ng／m1]水平明显高于非骨质破坏组[（1．2±1．0）U／L、（1．9±1．6）ng／ml]，同时骨形成标记物BALP[（26±7）U／L]水平也高于非骨质破坏组[（23±6）U／L，z值分别为-3．544，-3．429，-2．083；P〈0．05]。结论PsA存在骨代谢失衡情况即骨吸收、骨形成异常增强；骨代谢标记物水平的升高与骨质破坏发生密切相关。Objective To observe the bone metabolism of psoriatic arthritis （PsA） and investigate the roles of some bone metabolism markers such as tartrate-resistant acid phosphatase 5b （TRACP5）, C-terminal telopeptide of collagen- I （CTX- I ） and BALP in PsA patients with bone destructions. Methods Sixty-five cases of psoriatic arthritis, 30 cases of psoriasis and 30 cases of healthy people were enrolled. Bone mineral densities of lumbar spines and the left femoral necks were measured for all PsA patients using dual energy X-ray absorptiometry. The Serum levels of TRACP5b, CTX- I , BALP of healthy controls, Ps and PsA patients were measured. The PsA group was further divided into bone destruction group and none bone destruction group by image datasets. The levels of TRACP5b, CTX- I , BALP, PsAJAI, ESR and CRP from each group were detected. Mann-Whitney and X2 test were used for statistic analysis. Results TRACP5b levels of the healthy controls, Ps and PsA patients were （0.9±0.4）, （0.7±0.5） and （2.0±1.4） U/L respectively, and were significandy higher in the PsA patients than those of the other two groups （Z=-3.698, -3.638; P〈0.05）. The CTX- I levels of these three groups were （0.9±0.8）, （0.6±0.7） and （2.6±1.8） ng/ml respectively, and were also dramatically higher in the PsA patients than the other two groups （Z=-5.262, -5.734; P〈0.05）. BALP levels of each group were （22±4）, （22±4） and （25±7） U/L, and were also evidently higher in the PsA patients than patients in the other two groups （Z=-2.214,-2.000; P〈0.05）. Meanwhile, the levels of TRACP5b [（2.6±1.4） U/L], CTX- I [（3.1±1.8） ng/ml] and BALP [（26±7） U/L] were significantly higher in bone destruction group than those in the none bone destruction group [ （1.2±1.0） U/L, （1.9±1.6） ng/ml, （23± 6） U/L, Z=-3.544, -3.429, -2.083; P〈0.05]. Conclusion The high levels of TRACP5b, CTX- 1 and BALP in PsA indicate that there is bone metabolism imbalances in PsA. And the high level

关 键 词：关节炎 牛皮癣 骨质吸收 生物学标记 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]