骨代谢生化指标临床应用专家共识(2020)  

Expert consensus on clinical application of biochemical indicators of bone metabolism(2020)

作　　者：张萌萌 张秀珍[2] 邓伟民 张智海[4] 徐辉[5] 葛继荣 王永福[7] 黄宏兴 史晓林 张东伟 毛未贤 马倩倩 高远 杨茂伟[12] 郭郡浩 张红红[14] 张晓梅[15] 印平 赵方 郑洪新[18] 晁爱军[19] 张岩[20] 孔西建 李英华 李毅中[23] 赵国阳[24] 胡玲[25] 董红宇[26] 吴岩[27] 吴涤 邹军[29] 周惠琼 范馨月 ZHANG Mengmeng;ZHANG Xiuzhen;DENG Weimin;ZHANG Zhihai;XU Hui;GE Jirong;WANG Yongfu;HUANG Hongxing;SHI Xiaolin;ZHANG Dongwei;MAO Weixian;MA Qianqian;GAO Yuan;YANG Maowei;GUO Junhao;ZHANG Honghong;ZHANG Xiaomei;YIN Ping;ZHAO Fang;ZHENG Hongxin;CHAO Aijun;ZHANG Yan;KONG Xijian;LI Yinghua;LI Yizhong;ZHAO Guoyang;HU Ling;DONG Hongyu;WU Yan;WU Di;ZOU Jun;ZHOU Huiqiong;FAN Xinyue(Chinese Journal of Osteoporosis, Beijing 100102;Tongji Hospital Affiliated Tongji University,Shanghai 200065;General Hospital of Southern Theater of the COMMAND, Guangzhou 510010;Aviation General Hospital, Beijing 100012;Jilin University, Changchun 130012;Fujian Academy of Chinese Medical Sciences, Fuzhou 350003;The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010;The Third Affiliated Hospital of GuangzhouUniversity of Chinese Medicine, Guangzhou 510240;The Second Affiliated Hospital of ZhejiangUniversity of Chinese Medicine, Hangzhou 310005;Diabetes Research Center, BeijingUniversity of Chinese Medicine, Beijing 100029;FAW General Hospital of Jilin Province, Changchun 130011;The First Affiliated Hospital of China Medical University, Shenyang 110000;General Hospital of Eastern Theater of the COMMAND, Nanjing 210002;PLA General Hospital, Beijing 100853;Peking University International Hospital, Beijing 102206;Jinshan Hospital Affiliated to Dalian Medical University, Benxi 117000;Jinqiu Hospital of Liaoning Province, Shenyang 110016;Liaoning University of Traditional Chinese Medicine, Shenyang 110000;Tianjin Hospital, Tianjin 300211;Longhua Hospitalaffiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032;Henan Provincial Orthopedic Hospital, Luoyang 450000;The fifth People’s Hospital of Shanghai, Shanghai 200240;The Second Affiliated Hospital of FujianMedicalUniversity, Quanzhou 362000;Affiliated Hospital of Jiangsu University, Zhenjiang 212000;The Third Affiliated Hospital of Nanchang University, Nanchang 330000;Shijingshan Hospital, Capital Medical

机构地区：[1]《中国骨质疏松杂志》社,北京100102 [2]同济大学附属同济医院,上海200065 [3]中国人民解放军南部战区总医院,广东广州510010 [4]航空总医院,北京100012 [5]吉林大学,吉林长春130012 [6]福建省中医药科学院,福建福州350003 [7]内蒙古科技大学包头医学院第一附属医院,内蒙古包头014010 [8]广州中医药大学第三附属医院,广东广州510240 [9]浙江中医药大学附属第二医院,浙江杭州310005 [10]北京中医药大学糖尿病研究中心,北京100029 [11]吉林省一汽总医院,吉林长春130011 [12]中国医科大学附属第一医院,辽宁沈阳110000 [13]中国人民解放军东部战区总医院,江苏南京210002 [14]解放军总医院,北京100853 [15]北京大学国际医院,北京102206 [16]大连医科大学附属金山医院,辽宁本溪117000 [17]辽宁省金秋医院,辽宁沈阳110016 [18]辽宁中医药大学,辽宁沈阳110000 [19]天津医院,天津300211 [20]上海中医药大学附属龙华医院,上海200032 [21]河南省骨科医院,河南洛阳450000 [22]上海市第五人民医院,上海200240 [23]福建医科大学附属第二医院,福建泉州362000 [24]江苏大学附属医院,江苏镇江212000 [25]南昌大学第三附属医院,江西南昌330000 [26]首都医科大学北京市石景山医院,北京100043 [27]内蒙古医科大学,内蒙古呼和浩特010110 [28]内蒙古科技大学包头医学院,内蒙古包头014040 [29]上海体育学院,上海200438 [30]中国人民解放军总医院第四医学中心,北京100037 [31]大连医科大学附属第三医院,辽宁大连116000

出　　处：《中国骨质疏松杂志》2020年第6期781-796,共16页Chinese Journal of Osteoporosis

摘　　要：骨代谢生化指标包括钙磷代谢调节指标、骨形成标志物、骨吸收标志物、激素与细胞因子。骨代谢生化指标分别来源于骨、软骨、软组织、皮肤、肝、肾、小肠、血液及内分泌腺体等,是由成骨细胞或破骨细胞分泌的酶和激素,以及骨基质的胶原蛋白或非胶原蛋白代谢产物。骨代谢生化指标可及时反映骨转换状态,灵敏度高、特异性强,用于骨质疏松诊断分型、预测骨折风险、抗骨质疏松治疗疗效评价,以及代谢性骨病的诊断与鉴别诊断。并且在骨质疏松流行病学、发病机制、骨质疏松药物的研究方面具有重要的临床意义。本文对《骨代谢生化指标临床应用专家共识(2019)》进行了修订,共有41处修改,保留了经典文献,删减了部分内容,增加了近三年的文献,收集整理了骨代谢指标实验检测参考范围。The bone metabolic and biochemical markers include calcium and phosphorus metabolic indicators,bone formation markers,bone resorption markers,hormones,and cytokines.The bone metabolic and biochemical markers are derived from the bone,cartilage,soft tissue,skin,liver,kidney,small intestine,blood,and endocrine glands,respectively.They are enzymes and hormones secreted by osteoblasts or osteoclasts,and the bone metabolic products of collagen and non-collagen proteins in the matrix.The bone metabolic and biochemical markers reflect the state of bone turnover promptly,with high sensitivity and specificity.They have been applied in diagnosis of osteoporosis,prediction of fracture risk,curative effect observation of drug treatment,and the differential diagnosis of metabolic bone diseases.They have important clinical significances in epidemiology,pathogenesis,and drug research for osteoporosis.In this paper,the"Expert consensus on clinical application of biochemical indicators of bone metabolism(2019)"is revised.A total of 41 amendments have been made,the classic literatures are retained,some contents are deleted,and the literatures of the past three years are added.The experimental reference range of the bone metabolic indexes is collected and sorted.

关 键 词：骨代谢生化指标 钙磷代谢调节指标 甲状旁腺素 降钙素 维生素D3 25-羟基维生素D3 1 25-双羟基维生素D3 钙 磷 骨形成标志物 碱性磷酸酶 骨特异性碱性磷酸酶 骨钙素 I型前胶原C-端前肽 I型前胶原N-端前肽 骨保护素 骨吸收标志物 抗酒石酸酸性磷酸酶 I型胶原交联C-末端肽 I型胶原交联N-末端肽 尿吡啶啉 尿脱氧吡啶啉 激素 细胞因子 生长激素 雌激素 睾酮 白细胞介素-1 白细胞介素-6 转化生长因子β 肿瘤坏死因子 胰岛素样生长因子 

分 类 号：R336[医药卫生—人体生理学]