绝经后类风湿关节炎与骨性关节炎患者血清骨标志物比较  

Comparison of serum bone markers between the patients with postmenopausal rheumatoid arthritis and osteoarthritis

作　　者：雷旭杰[1] 郭丽[2] 林昌松[1] 

机构地区：[1]广州中医药大学第一附属医院风湿病科,广东广州510405 [2]广东省广州市荔湾区第二人民医院中医科,广东广州510370

出　　处：《实用临床医药杂志》2016年第9期67-69,72,共4页Journal of Clinical Medicine in Practice

基　　金：广东省中医药局科研课题资助项目(20132176);中国高校医学期刊临床专项资金(11523681)

摘　　要：目的探讨血清骨标志物β胶原特殊序列(β-Crosslaps)、总骨I型胶原氨基末端前肽(PⅠNP)、骨钙素(N-MID)在绝经后类风湿关节炎(RA)与骨性关节炎(OA)患者中的临床意义。方法选取绝经后RA(RA组)、OA患者(OA组)各50例,分别测定血清骨标志物、C反应蛋白(CRP)、血沉(ESR)、抗环瓜氨酸抗体(抗CCP)及骨密度,对比2组各指标差异,分析组内相关性。结果 RA组患者血清β-Crosslaps、CRP及ESR显著高于OA组(P<0.05或P<0.01),且β-Crosslaps与CRP、ESR呈显著正相关(P<0.01),PⅠNP与N-MID之间仍保持良好的相关性(P<0.01);CRP与ESR密切相关(P<0.01)。OA组血清β-Crosslaps与PⅠNP、N-MID呈显著正相关(P<0.01);骨密度与β-Crosslaps、年龄呈显著负相关(P<0.05或P<0.01)。结论血清β-Crosslaps可能受RA骨质破坏影响,有望成为检测RA骨破坏程度并评价治疗效果的指标。Objective To explore the clinical significance of serum bone markers such as β-Crosslaps,procollagen Ⅰ N-terminal peptide（ PⅠNP） and osteocalcin N-MID in the patients with postmenopausal rheumatoid arthritis（ RA） and patients with osteoarthritis（ OA）. Methods Fifty postmenopausal patients with RA（ RA group） and 50 cases of OA（ OA group） were selected,and the levels of serum bone markers,C-reactive protein（ CRP）,erythrocyte sedimentation rate（ ESR）,anti cyclic citrullinated peptide antibody（ anti-CCP） and bone mineral density（ BMD） were detected respectively. The difference of each indicator was compared between two groups,and the correlation among the indicators was analyzed. Results The levels of β-Crosslaps and CRP as well as ESR were significantly higher in RA group than those in OA group（ P〈 0. 05 or P〈 0. 01）. In postmenopausal patients with RA,β-Crosslaps was positively correlated with both CRP and ESR（ P〈 0. 01）,PⅠNP had a better correlation with N-MID（ P〈 0. 01）,and CRP was closely related with ESR（ P〈 0. 01）. In postmenopausal patients with OA,β-Crosslaps was positively correlated with both PⅠNP and N-MID（ P〈 0. 01）,and BMD was negatively correlated with β-Crosslaps and the age（ P〈 0. 05 or P〈 0. 01）. Conclusion Serum β-Crosslaps may be affected by the bone destruction of RA,and it is expected to be an indicator for detecting the bone destruction degree of RA and evaluating the therapeutic effect.

关 键 词：类风湿关节炎 骨性关节炎 骨标志物 绝经 

分 类 号：R593.22[医药卫生—内科学]