绝经后骨质疏松性腰椎骨折患者血清β-CTx、PINP水平及意义  

Serum levels of β-CTx and PINP in postmenopausal osteoporotic lumbar fractures and their significance

作　　者：占允中[1] 叶舟[1] 占蓓蕾[1] 张俊超 ZHAN Yunzhong;YE Zhou;ZHAN Beilei;ZHANG Junchoo(Department of Orthopedics,Quzhou People＇s Hospital in Zhejiang Province,Quzhou 324000,Chin)

机构地区：[1]浙江省衢州市人民医院骨科,浙江衢州324000

出　　处：《中国现代医生》2018年第20期9-12,共4页China Modern Doctor

基　　金：浙江省公益技术研究社会发展项目(2015C33294)

摘　　要：目的探讨绝经后骨质疏松性腰椎骨折患者血清Ⅰ型胶原羧基端肽β特殊序列(TypeⅠcollagen carboxyterminal peptideβ-specific sequence,β-CTx)、Ⅰ型前胶原氨基端前肽(TypeⅠprocollagen N-terminal propeptide,PINP)水平及意义。方法选择衢州市人民医院骨科2013年3月~2016年7月绝经后骨质疏松性腰椎骨折患者60例作为腰椎骨折组,绝经后骨质疏松无骨折患者60例作为对照组。测量髋部骨密度、腰椎骨密度和血清β-CTx、PINP水平。结果腰椎骨折组和对照组髋部骨密度和腰椎骨密度比较差异无显著性(P>0.05)。腰椎骨折组血清β-CTx、PINP水平高于对照组(P<0.05)。绝经后骨质疏松性腰椎骨折与血清β-CTx和PINP呈正相关(P<0.05)。β-CTx阈值为467.68 pg/m L时,诊断绝经后骨质疏松性腰椎骨折的ROC曲线下面积、敏感性、特异性分别为0.823、0.86、0.67;PINP阈值为29.34 ng/m L时,诊断绝经后骨质疏松性腰椎骨折的ROC曲线下面积、敏感性、特异性分别为0.651、0.89、0.43;β-CTx和PINP联合检测诊断绝经后骨质疏松性腰椎骨折的ROC曲线下面积、敏感性、特异性分别为0.891、0.94、0.83。结论绝经后骨质疏松性腰椎骨折患者血清β-CTx、PINP水平升高,β-CTx对绝经后骨质疏松性腰椎骨折的诊断价值高于PINP,两者联合检测对绝经后骨质疏松性腰椎骨折的诊断价值高于两者单独检测。Objective To investigate the serum levels of Type I collagen carboxy-terminal peptide β-specific sequence （β-CTx） and Type I procollagen amino terminal propeptide（PINP） in postmenopausal osteoporotic lumbar fractures and their significance. Methods 60 patients of postmenopausal osteoporotic lumbar fractures were selected as lumbar fracture group, and 60 cases of postmenopausal osteoporotic patients without fracture were selected as control group in the Quzhou City People＇s Hospital orthopedics from March 20β to July 2016.The bone mineral density, lumbar verte- brae bone mineral density and serum β-CTx and PINP levels were measured. Results There was no significant difference in hip bone mineral density and lumbar vertebrae bone mineral density between the lumbar vertebrae fracture group and the control group（P〉0.05）. The levels of serum β-CTx and PINP in the lumbar fracture group were higher than those in the control group（P〈0.05）. The postmenopausal osteoporotic lumbar fractures were positively correlated with serum β-CTx and serum PINP（P〈0.05）. When the β-CTx threshold was 467.68 pg/mL, the area under the ROC curve, sensitivity, specificity of β-CTx diagnosis the postmenopausal osteoporotic lumbar fracture postmenopausal osteo- porotic lumbar fractures were 0.823, 0.86 and 0.67 respectively. When the P1NP threshold was 29.34ng/mL, the area under the ROC curve, sensitivity, specificity of PINP diagnosis the postmenopausal osteoporotic lumbar fracture postmenopausal osteoporotic lumbar fractures were 0.651, 0.89, 0.43 respectively. The area under the ROC curve, sensitivity, specificity of β-CTx and PINP diagnosis the postmenopausal osteoporotic lumbar fracture postmenopausal osteoporotic lumbar fractures were 0.891, 0.94 and 0.83, respectively. Conclusion The serum β-CTx, PINP levels in patients with postmenopausal osteoporotic lumbar fractures increase. The diagnostic value of β-CTx on postmenopausal osteoporotic lumbar fractures is higher than PINP. The diagnostic value of

关 键 词：绝经后 骨质疏松 腰椎骨折 Ⅰ型胶原羧基端肽β特殊序列 Ⅰ型前胶原氨基端前肽 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]