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| 长期卧床老年人的骨代谢和维生素d2、d3水平的状况研究 |
| Bone metabolism and vitamin D level in long-term bed-rest senile patients：An observational study |
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| DOI：10.3969/j.issn.1006.7108.2015.11.009 |
| 中文关键词: 25羟基维生素D2(25(OH)D2)；25羟基维生素D3(25(OH)D3) 骨钙素N端（N-MID) β-胶原特殊序列（β-CIX) 甲状旁腺激素（PTH) |
| 英文关键词:25 Hydroxy vitamin D2 25 Hydroxy vitamin D3 Osteocalcin in N end-piece β-CrossLaps/serum Parathyroid hormone |
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| 中文摘要: |
| 目的 观察长期卧床老年人的骨代谢变化及体内维生素D2和D3水平。方法 随机选取126位长期卧床（1年以上）的住院患者作为研究组,36位同年龄段的健康人作为对照组，采用高效液相色谱-质谱联用法（LC-MS/MS)定量测定两组人群的维生素D2和D3，并测定骨代谢指标和生化指标，分析两组之间的差别。结果 研究组与对照组的的血清钙、磷浓度、PTH、CT相比无差异（P>0. 05);骨形成指标AKP、N-MID相比无差异（P>0.05);骨吸收指标β-CTX相比有明显区别（P <0.01.。两组的25羟基维生素D2浓度无显著差异，研究组的25羟基维生素D3 10. 48 ±6. 54 ng/ml明显低于对照组25羟基维生素D3 15. 40 ±8. 19 ng/ml(P<0.01)，总25羟基维生素D浓度研究组11.33 ±6.90 ng/ml也低于对照组15.33 ±8. 32 ng/ ml(P<0. 05)。总25羟基维生素D仅与PTH显著负相关,r= -0.362(P<0.01)。结论 卧床超过1年的老年人仍然存在骨吸收增高，骨丢失加快，同时维生素D缺乏明显,并加重了骨量流失。 |
| 英文摘要: |
| Objective To observe the bone metabolism and vitamin D levels in long-term bed-rest senile patients. Methods One hundred and twenty-six long-term bed-rest ( >1Year) patients were recruited as study group, and another 36 age-matched healthy patients were as control group. Vitamin D2 and vitamin D3 levels were tested using LC-MS/MS method. Bone metabolism markers were tested. The difference between the 2 groups was compared. Results There were no significant statistic differences between groups in serum calcium，phosphorus，PTH，and CT (P < 0. 05). The bone formation markers AKP and N-MID were not statistically significant between the 2 groups (P > 0. 05 ). The bone resorption marker β-CTX was statistically different between the 2 groups (P <0. 01). There was no significant difference between the 2 groups in 25(OH) vitamin D2 level. The mean 25(OH) vitamin D3 level was 10.48 ±6.54 ng/ml in study group, which was significantly lower than that in the control group (15.40 土 8. 19ng/ml, P<0. 01). The total 25(OH) vitamin D level was 11.33 ±6. 90 ng/ml in study group, which was also significantly lower than that in the control group (15. 33 ±8.32 ng/ml, P < 0. 05). The total 25 (OH) vitamin D level was significantly negatively correlated with PTH ( r = -0. 362, P <0. 01). Conclusion Bone resorption still increases in long-term bed-rest senile patients, leading to an accelerated bone loss. Meanwhile, vitamin D insufficiency in study group aggravates bone loss. |
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