骨代谢指标在老年女性原发性骨关节炎中骨质疏松症的诊断价值  

Diagnostic value of bone metabolism markers in osteoporosis in elderly women with primary knee arthritis

作　　者：王云秀 薛元霞 陈月萍 万泽民 黄妩姣 吴晓宾 许漫贤 WANG Yun-xiu;XUE Yuan-xia;CHEN Yue-ping;WANG Ze-ming;HUANG Wu-jiao;WU Xiao-bin;XU Man-xian(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510120;Liwan District Hospital,Guangzhou,Guangdong 510160;Medical Examination Department of Guangzhou Medical University,Guangzhou ,Guangdong510182,China)

机构地区：[1]广州中医药大学第二附属医院,广东广州510120 [2]广州市荔湾区中医医院,广东广州510160 [3]广州医科大学医学检验系,广东广州510182

出　　处：《热带医学杂志》2018年第12期1573-1575,1606,共4页Journal of Tropical Medicine

基　　金：广东省中医药管理局项目(20171095)

摘　　要：目的探讨血清骨代谢三项指标:Ⅰ型前胶原氨基末端肽(PINP)、N端骨钙素(N-MID)、β-胶原羧基末端肽(β-CTX)对60岁以上原发性骨关节炎(OA)女性患者骨质疏松症的诊断价值。方法回顾分析2013年1月至2017年1月广州中医药大学第二附属医院152例60岁以上OA女性患者的骨代谢及其骨密度(BMD)的检测结果。比较不同年龄组OA患者(60～70岁组,>70岁组)血清骨代谢结果的差异。以骨密度为标准,OA患者分为非骨质疏松组和骨质疏松组,比较两组之间骨代谢结果的差异。结果在60～70岁组和>70岁组的OA女性患者中,血清PINP、N-MID、β-CTX差异无统计学意义(P>0.05)。在骨质疏松组与非骨质疏松组中,血清PINP、β-CTX水平增高,差异有统计学意义(P<0.05),N-MID在两组之间差异无统计学意义(P>0.05)。以PINP和β-CTX分别单独预测60岁以上OA女性患者合并骨质疏松症的截断值(cut-off)分别为48.120 ng/mL、0.491 ng/mL。其中PINP检测灵敏度为57.3%,特异性为69.6%;β-CTX检测灵敏度为65.6%,特异性为69.9%;联合PINP、β-CTX检测灵敏度为68.8%,特异性为67.9%。结论临床检测血清PINP、β-CTX有助于对60岁以上OA女性患者发生骨质疏松症的预测和早期诊断,PINP、β-CTX联合检测灵敏度更高。Objective To investigate the diagnostic value of bone metabolic markers in the early diagnosis of osteoporosis in women with primary osteoarthritis(OA) over 60 years old. Methods The bone metabolism and bone mineral density(BMD) of 152 OA women over 60 years old in The second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2013 to January 2017 were analyzed retrospectively. The results of serum bone metabolism of OA patients in different age groups( 60~70 years old group and>70 years old group) were compared. On the basis of bone density, OA patients were divided into non-osteoporosis group and osteoporosis group, and the differences of bone metabolism between the two groups were compared. Results There was no significant difference in serum PINP, N-MID and(3-CTX between OA women aged 60~70 and >70(P>0.05). In the osteoporotic and non-osteoporotic groups of OA women over 60 years of age, the levels of serum pinp and β-CTX were significantly higher(P<0.05) than those of >70 years old group, while the differences of N-MID between the two groups were not statistically significant(P>0.05). Pinp and β-CTX were used to predict the cut-off values of osteoporosis in OA women over 60 years old, which were 48.120 ng/mL and 0.491 ng/mL,respectively. The sensitivity and specificity of PINP were 57.3% and 69.6%, respectively. The sensitivity and specificity of(3-CTX were 65.6%, 69.9%,68.8% and 67.9%, respectively. Conclusion Clinical detection of serum PINP and β-CTX is helpful to predict and early diagnose osteoporosis in OA women over 60 years of age. The sensitivity of PINP and β-CTX combined detection is higher than single marker.

关 键 词：骨代谢指标 原发性骨关节炎 骨质疏松症 

分 类 号：R684.3[医药卫生—骨科学]