中西药干预后肠源性5-羟色胺和骨密度的变化  

Changes of enterogenous 5-HT and bone mineral density after the intervention of traditional Chinese medicine and western medicine

作　　者：邓伟民[1] 张金赫[1] 刘泽[1] 张亚松[1] 康庐琛[2] 

机构地区：[1]广州军区广州总医院华侨楼(高级医疗康复中心),广州510010 [2]江西省九江市第一人民医院,江西九江332000

出　　处：《中国骨质疏松杂志》2014年第8期913-919,共7页Chinese Journal of Osteoporosis

基　　金：军队中医药科研专项课题计划(10ZYZ115);广东省国际合作项目(2012B050600026);广东省科学技术厅-广东省中医药科学院联合科研专项项目(2011B032200005);广东省自然科学基金博士启动基金(9451001002003887)

摘　　要：目的观察补肾壮骨冲剂和阿仑膦酸钠对骨质疏松症(osteoporosis,OP)患者的肠源性5-羟色胺(5-hydroxytryptamine,5-HT)浓度和骨密度的影响,探讨其作用机制。方法将120例原发性骨质疏松症患者分为补肾壮骨冲剂组和阿仑膦酸钠组,分析在药物治疗前后肠源性5-HT浓度和骨密度的差异。(1)本研究所有样本为2011年5月-2012年12月到广州军区广州总医院住院部及门诊部就诊的确诊为原发性骨质疏松症的患者。(2)肠源性5-HT测定:上午8:00～9:00抽取禁食12 h后空腹肘静脉血3 ml,3000 r/min即时离心5 min后,将血清置于-80℃冰箱保存,采用酶联免疫分析法检测5-HT的含量。(3)骨密度测定:采用美国GE公司生产的Lunar Prodigy双能X线(DEXA)骨密度仪,检测各部位BMD。(4)骨生化指标测定:采用酶联免疫分析法检测血清中肠源性5-HT的含量、电化学发光免疫分析法分析血清P1NP、β-Crosslaps、PTH的含量。结果补肾壮骨冲剂组治疗后左侧股骨颈、Ward’s三角和左侧股骨近端处骨密度上升,血清中的5-HT、PINP、β-Crosslaps及PTH浓度全面下降。阿仑膦酸钠组治疗后除腰椎外,其余各部位的骨密度都明显上升,血清中的5-HT、PINP、β-Crosslaps及PTH浓度全面下降。补肾壮骨冲剂组与阿仑膦酸钠组治疗后相关指标比较,两组骨密度改善情况未见明显差别,两组在治疗后的各项骨代谢指标改善情况未见明显差别。结论补肾壮骨冲剂和阿仑膦酸钠均可在提高骨密度同时减低肠源性5-HT浓度,与Ulrike提出的"肠源性5-HT与骨密度成负相关"这个结论相符。Objective To observe the effect of the nourishing kidney and strengthening bone granule and alendronate on the changes of enterogenous 5-hydroxytryptamine（ 5-HT） and bone mineral density（ BMD） in patients with osteoporosis（ OP）,and to explore its mechanism. Methods One hundred and tewenty patients with primary OP,who came to the inpatient and outpatient department in the Genenral Hospital of PLA Guangzhou Military Area from May 2011 to December 2012,were selected. All the patients were divided into the nourishing kidney and strengthening bone granule group and alendronate group. After 12-hour fasting,3ml fasting venous blood of each patient was collected during 8： 00-9： 00 am. The blood was instantly centrifuged（ 3000 r /min） for5 min,and the serum was stored in a- 80℃ refrigerator. The concentration of 5-HT in the serum was determined using ELISA.BMD of each part was detected using the dual energy X-rayabsorptiometry（ DEXA,Lunar Prodigy,GE Co.,USA）. The changes of 5-HT and BMD before and after the treatment were analyzed. The serum concentrations of P1NP,β-Crosslaps,and PTH were detected using electrochemiluminescence immunoassay. Results BMD of the left femoral neck,the Ward’s triangle,and the left proximal femur increased in the the nourishing kidney and strengthening bone granule group after the treatment,while the serum levels of 5-HT,PINP,β-Crosslaps,and PTH decreased. In alendronate group,except for BMD of the lumbar vertebrae,BMD of the rest parts increased obviously after the treatment. And the serum levels of 5-HT,PINP,β-Crosslaps,and PTH also decreased.According to the comparison of the related indexes between the nourishing kidney and strengthening bone granule group and alendronate group after the treatment,no significant difference of BMD between the two groups was observed. The changes of the bone metabolic indexes between the two groups before and after treatment also showed no significant differenc. Conclusion The nourishing kidney and strengthening bone granule and

关 键 词：5-羟色胺 骨密度 补肾壮骨冲剂 阿仑膦酸钠 

分 类 号：R969.4[医药卫生—药理学]