老年骨质疏松性骨折患者血清B-ALP、PTH、s-PINP和s-CTX表达  

The serum levels of B⁃ALP,PTH,s⁃PINP and s⁃CTX in elderly patients with osteoporotic fractures

作　　者：杨帅[1] 张红新[1] 古雪建 YANG Shuai;ZHANG Hongxin;GU Xuejian(Department of Orthopedics,First Central Hospital of Baoding,Baoding,Hebei,China,071000)

机构地区：[1]保定市第一中心医院骨五科,河北保定071000

出　　处：《分子诊断与治疗杂志》2021年第2期276-279,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生厅科研基金项目(20191713)。

摘　　要：目的探讨老年骨质疏松性骨折(OPF)患者血清骨特异性碱性磷酸酶(B-ALP)、甲状旁腺激素(PTH)、I型前胶原氨基端前肽(s-PINP)和I型胶原羧基端交联肽(s-CTX)水平及临床意义。方法选取2019年3月至2020年3月本院收治76例老年OPF患者作为OPF组,同期收治80例未发生骨折骨质疏松症(OP)患者作为对照组。比较两组腰椎(L2-4)、股骨颈、桡骨远端骨密度(BMD)、B-ALP、PTH、s-PINP和s-CTX水平;分析B-ALP、PTH、s-PINP和s-CTX水平与BMD的相关性;利用受试者工作特征曲线(ROC)评价B-ALP、PTH、s-PINP和s-CTX水平与发生OPF的关系。结果 OPF组腰椎(L2-4)、股骨颈、桡骨远端三个部位BMD水平均低于对照组,差异有统计学意义(P<0.05)。OPF组B-ALP、PTH、s-PINP、s-CTX水平均高于对照组,差异有统计学意义(P<0.05)。OPF组腰椎(L2-4)、股骨颈、桡骨远端三个部位BMD水平与B-ALP、PTH、s-PINP和s-CTX水平呈负相关(P<0.05)。绘制ROC曲线,B-ALP、PTH、s-PINP、s-CTX诊断OPF发生的AUC分别为0.663、0.625、0.729、0.690,四者联合诊断OPF发生的AUC为0.856,高于四者单独诊断AUC值。结论OPF患者血清B-ALP、PTH、s-PINP、s-CTX与BMD密切相关,且对评估OPF发生具有较高的诊断价值。Objective To explore the levels and clinical significance of serum bone⁃specific alkaline phosphatase(B⁃ALP),parathyroid hormone(PTH),N⁃terminal propeptide of type I precollagen(s⁃PINP)and carboxy⁃terminal cross⁃linking peptide of type I collagen(s⁃CTX)in elderly patients with osteoporotic fracture(OPF).Methods A total of 76 elderly OPF patients from March 2019 to March 2020 were enrolled as the OPF group,while another 80 osteoporotic(OP)patients without fracture admitted during the same period were enrolled as the control group.The bone mineral density(BMD)of lumbar spine(L2⁃4),femoral neck and distal radius,B⁃ALP,PTH,s⁃PINP and s⁃CTX levels were compared between the two groups.The correlation between B⁃ALP,PTH,s⁃PINP,s⁃CTX levels and BMD was analyzed.The relationship between B⁃ALP,PTH,s⁃PINP and s⁃CTX levels with OPF was evaluated by receiver operating characteristic(ROC)curves.Results BMD levels of lumbar spine(L2⁃4),femoral neck and distal radius in the OPF group were lower than those in the control group,the difference was statistically significant(P<0.05),while levels of B⁃ALP,PTH,s⁃PINP and s⁃CTX were higher than those in the control group,the difference was statistically significant(P<0.05).BMD levels of lumbar spine(L2⁃4),femoral neck and distal radius were negatively correlated with levels of B⁃ALP,PTH,s⁃PINP and s⁃CTX in the OPF group(P<0.05).According to the ROC curves,AUC values of B⁃ALP,PTH,s⁃PINP and s⁃CTX for diagnosis of OPF were 0.663,0.625,0.729 and 0.690,respectively.AUC of their combination was 0.856,higher than that of single indicator.Conclusion The serum B⁃ALP,PTH,s⁃PINP,and s⁃CTX of OPF patients are closely related to BMD,and have high diagnostic value for the evaluation of OPF.

关 键 词：老年骨质疏松 B-ALP PTH s-PINP s-CTX 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]