绝经后骨质疏松症伴骨关节炎骨量及骨代谢的研究  

Clinical study on change of bone mass and bone turnover in postmenopausal osteoporosis patients with osteoarthritis

作　　者：赵玺[1] 赵文[2] 彭海洲[2] 孙璟[2] 张赛男[2] 郑晓风[2] 

机构地区：[1]贵州省遵义医学院,遵义563000 [2]北京航天总医院,北京100076

出　　处：《中国矫形外科杂志》2013年第19期1937-1939,共3页Orthopedic Journal of China

基　　金：北京市丰台区基金资助项目(项目编号:2012-202)

摘　　要：[目的]通过对绝经后骨质疏松症(PMO)伴有不同程度膝骨性关节炎(KOA)的患者骨密度及骨代谢指标的比较,探讨老年女性中KOA发生与PMO的相关性。[方法]行双光能X线骨密度测定,筛选PMO病例328例,同时行膝关节X线片及骨代谢指标检查(BAP、BGP、CTX-1、TRACP5b、25-vitD3、PTH),对结果数据用SPSS统计软件进行统计学分析。[结果]单纯PMO患者与PMO伴不同程度KOA患者中,骨密度及BAP、CTX-1、TRACP5b值存在差异(P<0.05),其中KOAIV级以上患者骨密度明显升高,BAP、CTX-1、TRACP5b明显降低;但I级KOA患者CTX-1明显升高。[结论]骨质疏松可能是KOA发生发展的主要致病因素之一,但KOA的发生可能减低了骨吸收速率,从而阻碍了骨量的丢失。CTX-1作为一项敏感的骨代谢指标,在临床上对预测KOA发生和评价治疗效果有一定的参考价值。[Objective ] To study the effect of knee osteoarthritis （KOA） on postmenopausal osteoporosis （PMO） by measuring the bone mineral density （BMD） of lumbar and hip couple with bone metabolism markers （BTM） in groups of PMO patients with diffrernt grades of KOA. [ Methods] The sample of 328 PMO were assessed for radiographic features of KOA, and the BTM including BAP, BGP, CTX - 1, TRACPSb, 25 - vitD3, PTH serum levels were measured. The factors were compared among the patients with different classes of KOA. [ Results] BMD, BAP, CTX - 1, TRACP5b were different a- mong the PMO group and the PMO with different classes of KOA group. （ P 〈 0. 05） . The PMO with IV KOA group showed a significant higher BMD and lower serum levels of BAP, CTX - 1, TEACPSb compared with the PMO without KOA group. The PMO with I KOA group showed a significant higher serum level of CTX - 1 compared with the PMO without KOA group. [ Con- clusion ] The decrease of BMD contributes to the incidence of KOA. KOA could protect PMO patients from the decrease of BMD mediated by a lower rate of bone resorption. The serum level of CTX - 1 as a sensitive index provides an useful method to clinical diagnose and therapeutic effect detection of both KOA and PMO.

关 键 词：骨质疏松 膝骨性关节炎 绝经 骨密度 骨代谢指标 

分 类 号：R580[医药卫生—内分泌]