高原建设者骨代谢标志物的分布特点及影响因素分析  

Study on the distribution characteristics of bone metabolic markers in plateau builders and the influencing factors

作　　者：何清华[1] 周晓梅[1] 朱可[1] 唐晨[1] 高学明[1] 

机构地区：[1]四川电力医院内科,成都610021

出　　处：《华西医学》2017年第2期164-168,共5页West China Medical Journal

基　　金：成都市卫生局科研课题(2014090)

摘　　要：目的研究高原地区建设者骨形成标志物骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BALP)和骨吸收标志物Ⅰ型胶原交联羧基端肽区(typeⅠcollagen cross-linked C-telopeptide,CTX)、抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRAP)-5b的分布特征,分析其高原环境下的影响因素。方法 2014年4月—5月在海拔2 600~4 450 m[平均海拔(3 586.50±610.85)m]的四川省甘孜州巴塘县、西藏自治区芒康县境内,采用随机整群抽样的方式,抽取650名建设者作为研究对象,采集其空腹血,应用酶联免疫吸附试验检测血清BALP、CTX和TRAP-5b。应用SPSS 13.0软件分析年龄、工作强度、高原停留时间、工作地海拔高度等对骨代谢标志物的影响规律,探索高原环境下骨代谢标志物的主要影响因素。结果 CTX、TRAP-5b和BALP在20岁以下处于最高水平[CTX为(1.04±0.38)ng/m L,BALP为(52.09±14.62)μg/L,TRAP-5b为(4.22±1.38)U/L],以后随年龄增长均呈下降趋势,但CTX及BALP在40~49岁年龄组达到最低[CTX为(0.44±0.26)ng/m L,BALP为(24.77±9.89)μg/L],50岁后开始升高;而TRAP-5b在30~39岁年龄组达到最低[(2.59±0.95)U/L],40岁后开始升高。随着海拔高度增加,BALP和CTX的活性明显升高。随着劳动强度增加,BALP、TRAP-5b与CTX均增高。但无论何种劳动强度,随着高原停留时间延长,BALP先升高后降低;而TRAP-5b先降低后升高。结论骨代谢标志物在不同年龄段分布不同。海拔高度、工作强度及高原工作时间对骨代谢标志物有显著影响。Objective To study the distribution of bone-specific alkaline phosphatase（BALP）, type Ⅰ collagen cross-linked C-telopeptide（CTX） and tartrate-resistant acid phosphatase（TRAP）-5b in plateau area builders, and analyze the influencing factors under plateau environment. Methods Between April and May, 2014, using random stratified cluster sampling, we included in our study 650 blood samples from the power grid construction people in Batang County of Ganzi Autonomous Prefecture of Sichuan Province and Mangkang County of Tibet Autonomous Region with an altitude ranging from 2 600 to 4 450 meters, averaging（3 586.50±610.85） meters. We collected their fasting blood and detected their TRAP-5b, CTX and BALP by enzyme-linked immunosorbent assay method. By using SPSS 13.0, we analyzed the relationship between TRAP-5b, CTX, BALP and the influencing factors such as age, working intensity,residence time in the plateau area and altitude of the plateau. In the end, we tried to find out the main influencing factors of bone metabolic markers in the plateau environment. Results The levels of CTX, BALP and TRAP-5b were the highest before the age of 20, and the average levels of them were respectively（1.04±0.38） ng/m L,（52.09±14.62） μg/L, and（4.22±1.38） U/L. With the increase of age, the levels of CTX, TRAP-5b and BALP showed a downward trend, but CTX and BALP reached the lowest level in the age group of 40 to 49 years old, and the average levels of CTX and BALP were（0.44±0.26） ng/m L and（24.77±9.89） μg/L, respectively. Then they gradually increased after the age of 50. TRAP-5b reached the lowest level in the age group of 30 to 39 years old, and the average level of TRAP-5b was（2.59±0.95） U/L.Then it gradually increased after the age of 40. The activity of CTX and BALP increased obviously with the increase of altitude. With the increase of labor intensity, BALP, TRAP-5b and CTX all increased. However, no matter what labor intensity, the bone formation marker BALP first increased and th

关 键 词：骨代谢标志物 高原 海拔高度 工作强度 

分 类 号：R580[医药卫生—内分泌]