痛风患者肌骨超声表现与骨代谢标志物的相关性  

Correlation between musculoskeletal ultrasound changes and markers of bone metabolism in patients with gout

作　　者：王华南 叶风 郑颜萍 王敏[1] 王善志 王婷婷[2] 郭峰 李娟[1] WANG Huanan;YE Feng;ZHENG Yanping;WANG Min;WANG Shanzhi;WANG Tingting;GUO Feng;LI Juan(Department of Rheumatology and Immunology,First Affiliated Hospital of Hainan Medical University,Haikou 570102;Department of Nephrology,First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院风湿免疫科,海口570102 [2]海南医学院第一附属医院肾内科,海口570102

出　　处：《临床与病理杂志》2022年第6期1316-1320,共5页Journal of Clinical and Pathological Research

基　　金：海南省自然科学基金青年基金项目(820QN400)。

摘　　要：目的:探究痛风患者肌骨超声表现与骨代谢标志物的相关性。方法:选取2019年5月至2021年5月于海南医学院第一附属医院进行肌骨超声检查的155例痛风急性发作的患者。依据超声结果进行分组,超声下无特征性表现的患者为A组(n=48),表现为痛风石或聚集体或双轨征者为B组(n=55),表现为骨侵蚀伴或不伴有痛风石或聚集体或双轨征归入C组(n=52)。对比各组骨代谢标志物包括骨钙素(bone GLA protein,BGP)、Ⅰ型胶原交联C末端肽(C-terminal telopeptide of typeⅠcollagen,CTX-Ⅰ)、骨桥蛋白(osteopontin,OPN)水平,并分析其与临床指标的相关性。结果:C组BGP及OPN水平均显著高于B组和A组(P<0.05),且B组BGP、OPN水平显著高于A组(P<0.05);各组CTX-Ⅰ水平对比差异无统计学意义(P>0.05)。Pearson相关性分析显示:血清BGP、OPN水平与患者病程呈正相关(P<0.05),而血尿酸水平无明显相关性(P>0.05)。结论:肌骨超声可反映痛风患者关节骨损害程度,可作为痛风关节受累程度评估的影像学手段。Objective:To explore the correlation between musculoskeletal ultrasound changes and markers of bone metabolism in patients with gout.Methods:A total of 155 gout patients who underwent musculoskeletal ultrasound examination in our hospital from May 2019 to May 2021 were selected and divided into three groups according to the ultrasound results.Patients with no ultrasonographic lesions were classified into group A(n=48).Patients with gout stone or aggregation or double track sign were classified into group B(n=55).Patients with ultrasonographic erosion accompanied with or without gout stone,aggregation or double track sign were classified into group C(n=52).The levels of bone metabolism markers of bone GLA protein(BGP),Cross linked C-telopeptide of typeⅠcollagen(CTX-Ⅰ),and osteopontin(OPN)were compared in each group.And analyze their correlation with clinical indicators.Results:The levels of BGP and OPN in group C were significantly higher than those in group B and group A(P<0.05),and the levels of BGP and OPN in group B were significantly higher than those in group A(P<0.05).Pearson correlation analysis showed that serum BGP and OPN levels were positively correlated with the course of disease(P<0.05).There was no significant correlation between levels of serum uric acid and BGP or OPN(P>0.05).Conclusion:Musculoskeletal ultrasound can reflect the degree of joint bone damage in patients with gout,which can be used as an imaging method for evaluating the degree of joint involvement in gout.

关 键 词：痛风 肌骨超声 骨钙素 Ⅰ型胶原交联C末端肽 骨桥蛋白 

分 类 号：R589.7[医药卫生—内分泌]