糖皮质激素治疗SLE对骨代谢标志物的影响分析  

Impact of Glucocorticoid Therapy on Bone Metabolic Markers in System Lupus Erythematosus

作　　者：陈红[1] 徐霖[1] 吴立兵[2] 刘刚[2] 万华兵[2] 

机构地区：[1]湖北医药学院生物医学工程学院医学影像系,湖北十堰442000 [2]湖北医药学院附属太和医院核医学科,湖北十堰442000

出　　处：《标记免疫分析与临床》2015年第10期1004-1007,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的研究骨代谢标志物在糖皮质激素治疗系统性红斑狼疮(SLE)前后的变化,及其与治疗疗程进展的关系,探讨激素治疗后育龄期、围绝经期、绝经后女性患者骨代谢水平的特征;分析骨代谢标志物与骨密度在糖皮质激素治疗SLE中诊断骨质疏松的价值。方法检测40例SLE患者经糖皮质激素治疗前及治疗后3、6、12个月的骨代谢标志物(BGP、β-CTX、PICP),测定不同部位的骨密度,并运用统计学方法进行处理。结果 1糖皮质激素治疗前骨形成标志物和骨吸收标志物均较正常对照组明显降低(P<0.05),差异有统计学意义;2激素治疗早期,骨形成标志物BGP、PICP明显下降,骨吸收标志物β-CTX明显上升,治疗3、6、12个月后的骨代谢标志物水平与治疗前比较差异有统计学意义(P<0.05);3激素治疗后,围绝经期组较育龄期组β-CTX、PTH、FSH水平明显升高(P<0.05),绝经后组与围绝经期组比较,β-CTX、BGP、PICP、FSH均显著升高(P<0.05),差异有统计学意义。4糖皮质激素治疗3、6、12个月后测股骨近端、腰椎、Ward三角的骨密度,其不同部位骨密度的变化差异缺乏一致性。结论糖皮质激素治疗SLE患者,骨代谢标志物在治疗早期有明显变化;而同阶段不同部位骨密度变化存在差异,骨代谢标志物对早期诊断骨质疏松有重要意义,骨代谢标志物联合雌二醇(E2)可为围绝经女性骨质流失的评估提供参考。Objective To explore the changes of bone metabolism markers before and after glucocortieoid therapy in patients with system lupus erythematosus （ SLE ）, and its effect in the course of treatment as well as the diagnosis value of bone metabolism and bone mineral density in the treatment of SLE with glueocorticoid hormone, and to research the characteristics of the level of bone metabolism markers in childbearing, menopausal transition and postmenopause women. Methods The bone metabolism markers such as beta CTX, BGP, PICP in 40 patients with SLE before and after 3, 6 and 12 months treatment with osteoporosis were detected and the bone mineral density in different parts were also measured. Results The content of bone formed markers in patients with SLE before the treatment of glucocorticoid hormone was significantly decreased compared with that of normal controls （ P 〈 0.05 ）. In the early treatment stage, the bone formation sign BGP and PICP decreased and bone resorption marker beta CTX increased significantly, while there were statistically different on the levels of bone metabolism markers after 3, 6 and 12 months（P 〈0.05）. The beta CTX, FFH and FSH levels in menopausal transition group after therapy were significantly increased than that of the childbearing age group （ P 〈 0.05 ）. The beta CTX, PTH and FSH levels in perimenopausal groups were significantly increased compared with postmenopausal group （ P 〈 0.05 ）. The changes of bone mineral density on proximal femur, lumbar Spine and wards were consistency after treatment with glucocorticoid hormone. Conclusion In the early therapy stage, the bone metabolic markers has obvious change in the system lupus erythematosus patients after the treatment with glucocorticoid hormone, while the changes of bone mineral density in different parts are different. The bone metabolism markers have important significance in the early diagnosis of osteoporosis, and it can also provide a reference for evaluation of bone loss in postmenopausal women com

关 键 词：骨代谢标志物 骨密度 糖皮质激素 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]