血清骨桥蛋白、趋化素及碱性磷酸酶水平对胸腰椎骨质疏松性椎体压缩性骨折的预测价值  

Predictive value of serum levels of osteopontin,chemerin and alkaline phosphatase in thoracolumbar osteoporotic vertebral compression fractures

作　　者：刘晖 范小波[1] 庞超见 安彪 王永彬 Liu Hui;Fan Xiaobo;Pang Chaojian;An Biao;Wang Yongbin(First Department of Trauma and Orthopedics,First Hospital of Handan City,Handan 056002,Hebei,China)

机构地区：[1]邯郸市第一医院创伤骨一科,邯郸056002

出　　处：《脊柱外科杂志》2025年第2期109-113,135,共6页Journal of Spinal Surgery

基　　金：河北省医学科学研究课题计划项目(20231929)。

摘　　要：目的探讨血清骨桥蛋白(OPN)、趋化素及碱性磷酸酶(ALP)水平对胸腰椎骨质疏松性椎体压缩性骨折(OVCF)发生风险的预测价值。方法回顾性分析2021年9月—2023年2月就诊的126例胸腰椎骨质疏松症(骨质疏松组)患者资料,另选取同时期就诊的101例骨量下降患者(骨量下降组)和96名骨量正常的健康志愿者(对照组)资料进行对比。根据是否发生胸腰椎OVCF及椎体压缩程度对骨质疏松组患者进行亚组分析,采用logistic回归分析绘制受试者工作特征(ROC)曲线,并计算曲线下面积(AUC),分析血清OPN、趋化素、ALP水平对骨质疏松症患者发生胸腰椎OVCF的临床预测价值。结果骨质疏松组、骨量下降组和对照组血清OPN、趋化素、ALP水平差异均有统计学意义(P<0.05)。根据是否发生胸腰椎OVCF对骨质疏松组患者进行亚组分析,结果显示,骨折亚组血清OPN、趋化素、ALP水平高于未骨折亚组,差异均有统计学意义(P<0.05)。根据椎体压缩程度对骨质疏松组患者进行亚组分析,结果显示,血清OPN、趋化素、ALP水平,Ⅲ级亚组最高,Ⅱ级亚组次之,Ⅰ级亚组最低,差异均有统计学意义(P<0.05)。且3项指标联合预测较单一指标、任意2项指标联合预测骨质疏松症患者发生胸腰椎OVCF更有价值。结论血清OPN、趋化素、ALP水平升高均为骨质疏松症患者发生OVCF的危险因素,3项指标联合应用预测骨质疏松症患者发生胸腰椎OVCF发生风险具有更高的诊断效能。Objective To investigate the predictive value of serum osteopontin(OPN),chemerin and alkaline phosphatase(ALP)levels in the incidence of thoracolumbar osteoporotic vertebral compression fracture(OVCF).Methods From September 2021 to February 2023,the data of 126 thoracolumbar osteoporosis patients(osteoporosis group)were retrospectively analyzed,and 101 bone mass decreased patients(osteopenia group)and 96 normal bone mass healthy volunteers(control group)were selected for comparison.Subgroup analysis was conducted on osteoporosis group based on whether thoracolumbar OVCF occurred and the degree of vertebral compression.Logistic regression analysis was used to plot receiver operating characteristic(ROC)curves and calculate the area under the curve(AUC),to analyze the clinical value of serum OPN,chemerin and ALP levels in predicting OVCF in osteoporosis patients.Results The serum levels of OPN,chemokines and ALP in osteoporosis group,osteopenia group and control group were significantly different(P<0.05).According to the occurrence of thoracolumbar OVCF,patients in osteoporosis group were divided into subgroups.And the results showed that the serum OPN,chemokines,and ALP levels in the fracture subgroup were higher than those in the non-fracture subgroup,and the differences were statistically significant(P<0.05).According to the degree of vertebral compression,patients in osteoporosis group were divided into subgroups.And the results showed that the serum OPN,chemokines,and ALP levels were highest in grade Ⅲ subgroup,followed by grade Ⅱ subgroup,and lowest in grade Ⅰ subgroup,and the differences were statistically significan(t P<0.05).Moreover,the combined prediction of 3 indicators is more valuable than the single indicator or any combination of 2 indicators in predicting the occurrence of thoracolumbar OVCF in the osteoporosis patients.Conclusions Elevated serum OPN,chemokines and ALP levels are all risk factors for OVCF in osteoporosis patients.The combined application of the 3 indicators has higher diagnost

关 键 词：胸椎 腰椎 骨折 压缩性 骨质疏松 骨桥蛋白 趋化素 碱性磷酸酶 

分 类 号：R681.21[医药卫生—骨科学]