|
| 类风湿性关节炎合并骨质疏松的老年患者骨转换生化标志物水平的研究 |
| Study of the levels of biochemical bone turnover markers in elderly patients with rheumatoid arthritis combined with osteoporosis |
| |
| DOI：10.3969/j.issn.1006.7108.2015.12.004 |
| 中文关键词: 类风湿性关节炎；骨质疏松 骨转换生化标志物；骨钙素；骨特异性碱性磷酸酶 I型胶原交联C-末端肽 |
| 英文关键词:Rheumatoid arthritis Osteoporosis Biochemical markers of bone turnover Osteocalcin Bone-specific alkaline phosphatase Type I collagen cross-linking C terminal peptide |
| 基金项目:全军十二五课题（CWS11J169) |
|
| 摘要点击次数: 580 |
| 全文下载次数: 534 |
| 中文摘要: |
| 目的 探讨类风湿性关节炎合并骨质疏松的老年患者骨转换生化标志物的水平。方法 选择2008年1月至2014年4月在我科住院的73例患者,包括类风湿性关节炎合并骨质疏松患者35例，年龄（64. 51 ± 13. 27)岁，原发性骨质疏松患者38例，年龄（65. 42 ±8. 86)岁。采用美国Norland双光能X线骨密度检测仪对所有患者进行腰椎L2-4和左侧股骨近端（包括 Neck、Troch、Ward’s三角区）骨密度测量，并测定身高、体重、血谷丙转氨酶（ALT)、谷草转氨酶（AST)、肌酐（CRE)、尿素氮 (BUN)。采用酶联免疫吸附法测定两组患者血清骨钙素（OC)、骨特异性碱性磷酸酶（BAP)、1型胶原交联C-末端肽（S- CTX)，比较两组血清OC、BAP、S-CTX水平。结果 类风湿性关节炎合并骨质疏松组患者骨形成指标血清OC( 13. 5654 ± 8.8701)ng/mL,较原发性骨质疏松患者（9.3113 ±6. 7816) ng/mL高，差异具有统计学意义（P<0.05);类风湿性关节炎合并骨质疏松组患者骨形成指标BAP( 15. 7274 ±5. 3279)ug/L，与原发性骨质疏松患者（16. 7539 ±7. 0390)ug/L相比无统计学意义（P >0. 05);类风湿性关节炎合并骨质疏松组患者骨吸收指标S-CTX(0. 7746 ±0. 7149)ng/ml，比原发性骨质疏松患者（0. 3346 ± 0. 1668)ng/ml高，差异具有统计学意义（P < 0. 05 );类风湿性关节炎合并骨质疏松组患者身高（162. 60 ± 6. 87 ) cm、体重 (60. 54 ±9. 87)kg、ALT(20. 19 ± 16. 56) IU/L、AST(20. 09 ± 10. 41 )IU/L、CRE(64. 55 ± 19. 51) umol/L,BUN(5. 75 ± 1. 97) mmol/ L,与原发性骨质疏松组身高（161. 92 ±9. 33)cm、体重（64. 85 ± 11. 86)kg、ALT(23. 91 ±15. 87) IU/L、AST(21. 32 ±8.72)IU/L、 CRE(63. 79 ± 13. 4260) umol/L、BUN(5. 27 ± 1. 60)mmol/L相比，差异无统计学意义（P >0. 05);类风湿性关节炎合并骨质疏松患者 L2-4、Neck、Troch、Ward’s 三角区的骨密度分别为（0. 8600 ± 0. 1637 ) g/cm2、（ 0. 6840 ± 0.0. 1355 ) g/cm2 、(0. 5831 ± 0. 1225)g/cm2、(0.5181 ±0. 1304)g/cm2,与原发性骨质疏松组（0. 8744 ±0. 1668)g/cm2 ,(0. 7426 ±0. 1686)g/cm2、（0. 5995 ± 0. 1088) g/cm2 , (0. 5459 ±0. 1088) g/cm2相比，差异没有统计学意义（P >0. 05)。结论 类风湿性关节炎合并骨质疏松患者较原发性骨质疏松患者骨转换活跃。 |
| 英文摘要: |
| Objective To study the levels of biochemical bone turnover markers in elderly patients with rheumatoid arthritis combined with osteoporosis. Methods Seventy-three cases who attended in our hospital from Jan. 2008 to Apr. 2014 were selected, including 35 patients (64. 51 ±13. 27 years old) with rheumatoid arthritis combined with osteoporosis and 38 patients (65. 42 ± 8. 86 years old) with primary osteoporosis. Bone mineral density of L2-L4 and the left femurs (neck, Troch, and Ward’s triangle) were measured using dual energy X-ray absorptiometry (DEXA). The height, body weight, ALT, AST, CRE, and BUN were examined. Osteocalcin (OC), bone-specific alkaline phosphatase (BAP)，and type I collagen cross-linking C terminal peptide (S-CTX) were measured with enzyme linked immunosorbent assay and the levels of bone markers were compared. Results The bone formation marker OC was higher in patients with rheumatoid arthritis combined with osteoporosis (13. 5654 ±8. 8701 ng/ml) than that in control group (9. 3113 ±6.7816 ng/ml), with statistical significance (P <0. 05). The bone formation marker BAP was not statistically different between patients with rheumatoid arthritis combined with osteoporosis (15. 7274 ±5. 3279 ug/1) and in control group ( 16. 7539 ±7,0390 ug/1, P >0.05). The bone resorption marker S-CTX was higher in patients with rheumatoid arthritis combined with osteoporosis (0. 7746 ±0,7149 ng/ml) than that in control group (0. 3346 ±0. 1668 ng/ml)，with statistical difference (P <0.05), The height, weight, ALT, AST, CRE, and BUN in patients with rheumatoid arthritis combined with osteoporosis (162. 60 ±6. 87 cm，60. 54 ±9. 87 kg, 20. 19 ± 16. 56 IU/L, 20. 09 ± 10. 41 IU/L, 64. 55 ± 19. 51 umol/L, and 5. 75±1.97 mmoI/L, respectively) were not different compared to those in control group (161.92 ±9.33 cm, 64, 85 ±11.86 kg, 23. 91 ±15, 87 IU/L, 21. 32 ±8. 72 IU/L, 63. 79 ± 13.4260 umol/L，and 5. 27 ± 1. 60 mmol/L, respectively). The BMD of L2- 4, Neck, Troch, and Ward’s triangle were 0. 8600 ± 0. 1637 g/cm2, 0. 6840 ±0.0. 1355 g/cm2，0. 5831± 0. 1225 g/cm2, and 0.5181 ±0. 1304 g/cm2 in patients with rheumatoid arthritis combined with osteoporosis and 0. 8744 ±0. 1668 g/cm2, 0.7426 ± 0. 1686 g/cm2, 0. 5995 ±0. 1088g/cm2, and 0.5459 ±0- 1088 g/cm2 in control group, respectively. The BMD results were not different between the two groups (P>0. 05). Conclusion The bone turnover is more active in rheumatoid arthritis combined with osteoporosis patients than in primary osteoporosis patients. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|