骨折患者长期固定治疗尿脱氧吡啶啉变化的临床研究  

The Clinical Research on the Changes of Urinary Deoxypyridinoline in Bedridden Fracture-patients with Long-term Treament

作　　者：石胜[1] 许鸿灏[1] 熊美珍[1] 王小朝[1] 司徒良[1] 

机构地区：[1]广东省江门市人民医院骨科,广东江门529000

出　　处：《中国医师杂志》2004年第4期445-447,共3页Journal of Chinese Physician

摘　　要：目的　探讨骨折长期固定治疗患者尿脱氧吡啶啉的变化及其临床意义。方法　测定 3 7例 (男 2 2例 ,女 15例 )骨折长期固定治疗患者及 3 0例 (男 15例 ,女 15例 )健康对照者的血清钙 (Ca)、磷 (P)、总碱性磷酸酶 (AKP)、尿钙 /肌酐 (Ca/Cr)、尿脱氧吡啶啉 (DPD)的水平。结果　骨折长期固定治疗患者血清钙、磷水平较正常对照组显著降低 (P <0 0 5 ) ;AKP、Ca/Cr、DPD水平较正常对照组有不同程度的增高 (P <0 0 5 ,P <0 0 5和P <0 0 1)。其中以尿DPD的活性增高更为显著 (增高 5 98倍 )。而且 ,骨折长期固定治疗患者尿DPD的变化还与病程呈正相关。结论　尿DPD是反映骨吸收的一项敏感而特异的指标 ,尿DPD的监测对骨折长期固定治疗患者的临床治疗和预防发生新的骨折具有重要的参考价值。Objective To explore the changes of urinary deoxypyridinoline and its clinical significance in bedridden fracture-patients with long-term treatment. Methods Thirty-seven bedridden fracture-patients with long-term treatment(22 males and 15 females) and thirty healthy subjects(15 males and 15 females) were selected for analyzing the levels of serum calcium(Ca), phosphate(P), total serum alkaline phosphatase(AKP),urinary calcium/creatinine ratio(Ca/Cr) and urinary deoxypyridinoline(DPD). Results The concentration of serum calcium and phosphate in the patients was significantly lower than that in the healthy subjects (P<0.05), while the levels of serum AKP, urinary Ca/Cr and urinary DPD in the patients were significantly higher than those in the healthy subjects (P<0.05,P<0.05,P<0.01, respectively), and the level of urinary DPD increased the most notably among the all indices. And the changes of urinary DPD in patients were also positively related to the disease course. Conclusion DPD is a sensitive and specific biochemical index of bone absorption. The analysis of urinary DPD may have some reference value for the patients' treatment and preventing the bedridden fracture-patients with long-term treatment from occurring a new fracture.

关 键 词：骨折 骨代谢 骨质疏松 尿脱氧吡啶啉 骨细胞 

分 类 号：R683[医药卫生—骨科学]