高原藏族绝经后妇女不同部位骨密度的变化规律及其与生化指标的关联性  

Changes of Bone Mineral Density in Different Parts of Tibetan Postmenopausal Women at High Altitude and Its Correlation with Biochemical Indexes

作　　者：谢春 李作瑞 史纲 张武花 谢录玲 马建萍 XIE Chun;LI Zuorui;SHI Gang;ZHANG Wuhua;XIE Luling;MA Jianping(Department of Imaging,The Fifth People’s Hospital of Qinghai Province,Xining Qinghai 810001,China;Department of Radiology,Qinghai Hospital of Traditional Chinese Medicine,Xining Qinghai 810000,China)

机构地区：[1]青海省第五人民医院影像科,青海西宁810001 [2]青海省中医院放射科,青海西宁810000

出　　处：《中国医疗设备》2022年第7期144-147,共4页China Medical Devices

基　　金：国家癌症中心攀登基金项目(NCC201929B01)。

摘　　要：目的分析高原藏族绝经后妇女不同部位骨密度(Bone Mineral Density,BMD)的变化规律及其与生化指标的关联性。方法将117例高原藏族绝经后妇女作为观察组,29例未绝经女性作为对照组,根据BMD值检测结果将观察组分为骨量正常组、骨质疏松组。比较各组实验对象不同部位(腰椎L2~L4、股骨颈、华氏三角、股骨粗隆)的BMD值,并分析其与血清骨特异性碱性磷酸酶(Alkaline Phosphatase,ALP)、血清骨钙素(Bone Gla-protein,BGP)、抗酒石酸酸性磷酸酶(Tartrate-Resistant Acid Phosphatase-5b,TRAP-5b)、基质金属蛋白酶-2(Matrix Metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(Matrix Metalloproteinase-9,MMP-9)、骨钙素(Osteocalcin,OC)、I型胶原氨基末端肽(Amino Terminal Peptide of Type I Collagen,NTx)、雌激素(Estrogen,E_(2))、卵泡刺激素(Follicle Stimulating Hormone,FSH)、磷(Phosphorus,P)、甲状旁腺激素(Parathyroid Hormone,PTH)水平的相关性。结果骨量正常组不同部位的BMD值均较对照组显著降低(P<0.05);骨质疏松组不同部位的BMD值均较骨量正常组显著降低(P<0.05)。与对照组相比,骨量正常组血清E_(2)、P水平均显著降低,血清ALP、BGP、TRAP-5b、MMP-9、NTx、FSH、PTH水平均显著升高(P<0.05)。与骨量正常组相比,骨质疏松组血清E_(2)、P水平均显著降低,血清ALP、BGP、TRAP-5b、MMP-2、MMP-9、NTx、OC、FSH、PTH水平均显著升高(P<0.05)。骨质疏松症组不同部位BMD值与血清ALP、BGP、TRAP-5b、MMP-2、MMP-9、NTX、OC、FSH、PTH呈负相关(P<0.05),与血清E_(2)、P呈正相关(P<0.05)。结论高原藏族绝经后骨质疏松症妇女BMD值明显低于绝经前,血清ALP、BGP、TRAP-5b可反映骨代谢活动,其BMD值减少与骨转换率增加密不可分。Objective To analyze the changes of bone mineral density(BMD)in different parts of Tibetan postmenopausal women at high altitude and its correlation with biochemical indexes.Methods A total of 117 Tibetan postmenopausal women were selected as the observation group and 29 premenopausal women as the control group.The observation group was divided into normal bone mass group and osteoporosis group according to the results of BMD.The BMD values of different parts of lumbar L2-L4,femoral neck,ward triangie and triangle of femur were compared in each group.And the relationship between BMD and the levels of serum bone specific alkaline phosphatase(ALP),serum Boneglaprotein(BGP),tartrate-resistant acid phosphatase-5b(TRAP-5b),matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),osteocalcin(OC),amino terminal peptide of type I collagen(NTx),estrogen(E_(2)),follicle stimulating hormone(FSH),phosphorus(P)and parathyroid hormone(PTH)were analyzed.Results The BMD values in different parts of normal bone mass group were significantly lower than those in control group(P<0.05).The BMD value in different parts of osteoporosis group were significantly lower than those in normal bone mass group(P<0.05).Compared with the control group,serum E_(2) and P levels in normal bone mass group were significantly decreased,while serum ALP,BGP,TRAP-5b,MMP-9,NTx,FSH and PTH levels were significantly increased(P<0.05).Compared with normal bone mass group,serum E_(2) and P levels in osteoporosis group were significantly decreased,while serum ALP,BGP,TRAP-5b,MMP-2,MMP-9,NTx,OC,FSH and PTH levels were significantly increased(P<0.05).The BMD values in different parts of osteoporosis group were negatively correlated with serum ALP,BGP,TRAP-5b,MMP-2,MMP-9,NTx,OC,FSH and PTH(P<0.05),but positively correlated with serum E_(2) and P(P<0.05).Conclusion The BMD value of Tibetan postmenopausal women with osteoporosis is significantly lower than that of premenopausal women.The serum ALP,BGP,TRAP-5b can reflect bone metabolic activity,and the d

关 键 词：骨质疏松 高原藏族 骨密度 血清指标 骨钙素 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学] R711[医药卫生—基础医学]