绝经后H型高血压合并骨质疏松症患者血清MCP-1、PTX3、GDF15的变化及其临床意义分析  

Changes and Clinical Significance Analysis of Serum MCP-1,PTX3 and GDF15 in Postmenopausal Patients with H-Type Hypertension and Osteoporosis

作　　者：卜秋宁 凌超 刘匀[1] 张钰 马翠花[1] Bu Qiuning;Ling Chao;Liu Yun(Department of Clinical Laboratory,Qinhuangdao First Hospital,Qinhuangdao,Hebei 066000;Department of Orthopedics,Qinhuangdao Workers Hospital,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院检验科,河北秦皇岛066000 [2]秦皇岛市工人医院骨科,河北秦皇岛066000

出　　处：《四川医学》2024年第7期703-708,共6页Sichuan Medical Journal

基　　金：河北省医学科学研究课题(编号:20201316)。

摘　　要：目的分析绝经后H型高血压(HHT)合并骨质疏松症(OP)患者血清单核细胞趋化蛋白(MCP)-1、正五聚蛋白3(PTX3)、生长分化因子15(GDF15)的变化及其临床意义。方法选取2020年6月至2023年5月我院收治的127例绝经后HHT合并OP患者为研究组,另选取同期85例绝经后OP患者为OP组,62例绝经后单纯HHT患者为HHT组、60例体检健康的绝经后女性志愿者为健康组。比较4组血清MCP-1、PTX3、GDF15水平、股骨颈和腰椎(L_(1~4))骨密度、血清骨代谢指标[骨钙素(BGP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型前胶原氨基端前肽(PINP)]及炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)]。采用Pearson相关性分析血清MCP-1、PTX3、GDF15水平与骨密度、血清骨代谢指标及炎症因子的相关性。采用受试者工作特征(ROC)曲线分析血清MCP-1、PTX3、GDF15对绝经后HHT合并OP的诊断价值。结果与健康组比较,OP组、HHT组及研究组血清MCP-1、PTX3、GDF15、BGP、β-CTX、PINP水平均较高,且OP组高于HHT组,研究组高于OP组和HHT组(P<0.05)。与健康组比较,OP组、HHT组及研究组血清TNF-α、IL-6水平均较高,且HHT组高于OP组,研究组高于OP组和HHT组(P<0.05)。与健康组比较,OP组、HHT组及研究组的股骨颈和腰椎(L_(1~4))骨密度均较低,且OP组低于HHT组,研究组低于OP组和HHT组(P<0.05)。Pearson相关性分析显示,血清MCP-1、PTX3、GDF15水平与股骨颈和腰椎(L_(1~4))骨密度呈负相关,与血清BGP、β-CTX、PINP、TNF-α、IL-6水平呈正相关(P<0.05)。ROC曲线分析显示,血清MCP-1、PTX3、GDF15联合诊断绝经后HHT合并OP的AUC值为0.945,高于单独指标诊断。结论绝经后HHT合并OP患者血清MCP-1、PTX3、GDF15水平升高,且与股骨颈和腰椎(L_(1~4))骨密度、血清骨代谢指标及炎症因子密切相关,三者联合检测对诊断绝经后HHT合并OP患者有较高价值。Objective To analyze changes and clinical significance of serum monocyte chemoattractant protein-1(MCP-1),pentraxin 3(PTX3)and growth differentiation factor 15(GDF15)in postmenopausal patients with H-type hypertension(HHT)and osteoporosis(OP).Methods 127 postmenopausal patients with HHT and OP who were admitted from June 2020 to May 2023 were selected as study group,another 85 postmenopausal patients with OP were selected as OP group,62 postmenopausal patients with HHT alone were selected as HHT group,and 60 healthy postmenopausal female volunteers were selected as healthy group.Serum MCP-1,PTX3,GDF15,bone mineral density of femoral neck and lumbar spine(L_(1~4)),serum bone metabolism indexes[osteocalcin(BGP),type I collagen carboxy terminal peptideβspecial sequence(β-CTX),type I procollagen amino terminal propeptide(PINP)]and inflammatory factors[tumor necrosis factorα(TNF-α),interleukin-6(IL-6)]were compared among four groups.The correlation between serum MCP-1,PTX3,GDF15 and bone mineral density,serum bone metabolism indexes and inflammatory factors were analyzed by Pearson correlation analysis.Diagnostic value of serum MCP-1,PTX3 and GDF15 in postmenopausal with HHT and OP were analyzed by receiver operating characteristic(ROC)curve.Results Compared with healthy group,serum MCP-1,PTX3,GDF15,BGP,β-CTX and PINP in OP group,HHT group and study group were higher,and OP group was higher than that of HHT group,study group was higher than that of OP group and HHT group(P<0.05).Compared with healthy group,serum TNF-αand IL-6 in OP group,HHT group and study group were higher,and HHT group was higher than that of OP group,and study group was higher than that of OP group and HHT group(P<0.05).Compared with healthy group,bone mineral density of femoral neck and lumbar spine(L_(1~4))in OP group,HHT group and study group were lower,and OP group was lower than that of HHT group,and study group was lower than that of OP group and HHT group(P<0.05).Pearson correlation analysis showed that,serum MCP-1,PTX3 and GDF15 were

关 键 词：H型高血压 骨质疏松症 单核细胞趋化蛋白-1 正五聚蛋白3 生长分化因子15 

分 类 号：R544.1[医药卫生—心血管疾病] R580[医药卫生—内科学]