骨代谢标志物在老年痴呆患者骨质疏松症早期诊断中的临床价值  

Clinical significance of bone metabolism index in the early.diagnosis of osteoporosis in patients with Alzheimer's disease

作　　者：查显友[1] 周燕[1] 费玉娥[1] CHA Xian-you;ZHOU Yan;FEI Yu-e(Kang-ci Hospital of Jiaxing,Jiaxing,Zhejiang 314500,China)

机构地区：[1]嘉兴市康慈医院,浙江嘉兴314500

出　　处：《中国卫生检验杂志》2022年第13期1582-1585,共4页Chinese Journal of Health Laboratory Technology

基　　金：桐乡市科技计划项目(201902254)。

摘　　要：目的 分析骨代谢标志物测定用于老年痴呆患者骨质疏松症早期诊断的临床价值。方法 选择老年痴呆患者100例作为疾病组,根据检测骨密度不同将其分为骨质正常组、骨量减少组和骨量疏松组,同时选取同时期住院年龄相仿的非痴呆老年人60例作为对照组,对所有研究对象进行临床痴呆评定量表(CDR)、简明心理状况(MMSE)的评定以及血液中骨代谢标志物水平的测定,包括血钙(Ca)、血磷(P)、碱性磷酸(ALP)、甲状旁腺激素(PTH)、总I型前胶原氨基末端肽(PINP)、25羟基维生素D[25(OH) D]和β-型胶原分解产物(β-CTX),并对其进行比较分析。结果 老年痴呆患者骨质疏松的发生率明显高于对照组,疾病组β-CTX、PTH水平明显高于对照组,25(OH) D、血Ca水平明显低于对照组,差异均有统计学意义(P <0.05);发现骨质疏松组的血Ca、25(OH) D、腰椎BMD和股骨颈BMD的水平均低于骨量减少组和骨量正常组,β-CTX和PTH水平明显高于骨量减少组和骨量正常组,差异均有统计学意义(P <0.05)。相关分析显示PTH和β-CTX与老年痴呆患者骨质疏松发生率成正相关(P <0.01),25(OH) D则与老年痴呆患者骨质疏松发生率成负相关(P <0.01)。结论 老年痴呆患者骨质疏松发病率较高,PTH、β-CTX和25(OH) D水平可作为预测老年痴呆患者并发骨质疏松症早期的有效指标。Objective To analyze the clinical significance of bone metabolism index in the early diagnosis of osteoporosis( OP)in patients with Alzheimer’s disease. Methods A total of 100 patients with Alzheimer’s disease were enrolled as the disease group( normal bone mass group,osteoporosis group and severe osteoporosis group according to the bone mineral density). At the same time,60 elderly non dementia elderly patients were selected as the control group. All subjects were assessed by clinical dementia rating scale( CDR),concise mental state( MMSE) and blood bone metabolism markers levels were measured and compared,including blood calcium( CA),blood phosphorus( P),alkaline phosphate( ALP),parathyroid hormone( PTH),procollagen type I amino-terminal propeptide( PINP),25 hydroxyvitamin D [25( OH) D] and bone resorption marker β type collagen breakdown products( β-CTX). Results The incidence of osteoporosis in Alzheimer’s patients was significantly higher than that in the control group,these patients of β-CTX and parathyroid hormone levels were significantly higher than those in the control group. The levels of 25( OH) D and blood Ca were significantly lower than those in the control group,with the differences statistically significant( P < 0. 05). The levels of blood Ca,25( OH) D,lumbar BMD and femoral neck BMD in osteoporosis group were lower than those in osteopenia group and normal bone mass group. The levels of β-CTX and PTH were significantly higher than those in osteopenia group and normal bone mass group,with the differences statistically significant( P < 0. 05). Correlation analysis showed that PTH and β-CTX was positively correlated with the incidence of osteoporosis in patients with Alzheimer’s disease( P < 0. 01),and 25( OH) D was negatively correlated with the incidence of osteoporosis in patients with Alzheimer’s disease( P < 0. 01). Conclusion The incidence rate of osteoporosis is high in senile dementia patients. The levels of PTH,β-CTX and 25( OH) D can be used as effective indicators to pred

关 键 词：骨代谢标志物 骨质疏松症 老年痴呆症 

分 类 号：R68[医药卫生—骨科学]