骨质疏松症合并膝骨性关节炎患者骨密度及血清骨代谢指标、炎症因子水平研究
Study of bone mineral density, serum bone metabolism indexes, and inflammatory factors in osteoporotic patients with osteoarthritis
  
DOI:10.3969/j.issn.1006-7108.2019.08.013
中文关键词:  膝骨性关节炎  绝经后骨质疏松症  骨代谢  骨密度  细胞因子
英文关键词:knee osteoarthritis  postmenopausal osteoporosis  bone metabolism  bone mineral density  cytokines
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尹伟 杨斌辉 张波 周娟 卫永鲲* 西安交通大学附属汉中三二〇一医院陕西 汉中 723000 
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中文摘要:
      目的 观察绝经后骨质疏松症(osteoporosis, OP)合并膝骨性关节炎患者骨密度、骨代谢相关指标以及细胞因子水平的特点。方法 纳入78例绝经后骨质疏松症患者为OP组,75例绝经后骨质疏松症合并膝骨性关节炎患者为OPA组,76例膝骨性关节炎患者为KOA组。观察3组患者血清骨代谢指标骨钙素(BGP)、血清抗酒石酸酸性磷酸酶异体(TRACP-5b) 、骨碱性磷酸酶(BAP)及I型胶原交联C末端肽(CTX-1)水平;炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1 (TGF-β1) 及白细胞介素-10(IL-10)水平以及左髋、正位腰椎1-4(L1~4)的骨密度情况。结果 OPA组血清BGP、TRACP-5b、BAP、BGP、CTX-1水平高于OP组(P<0.05),而KOA组低于OP组(P<0.05)。KOA组血清TGF-β1 水平高于OP组(P<0.05),而血清 IL-6、TNF-α 及IL-10水平显著低于OP组(P<0.05);KOA组血清 IL-6、TNF-α 及IL-10水平高于OP组(P<0.05),而TGF-β1 水平低于OP组(P<0.05)。OP组及OPA组L1-4及左髋部骨密度显著低于KOA组(P<0.05)。结论 绝经后骨质疏松症合并膝骨性关节炎患者的骨密度及骨代谢不同程度减低,而细胞因子水平升高,治疗时需要关注免疫异常。
英文摘要:
      Objective To observe the characteristics of bone mineral density (BMD), bone metabolism indexes, and cytokine levels in patients with osteoarthritis of knee and postmenopausal osteoporosis. Methods 78 postmenopausal osteoporotic patients were divided into OP group, 75 postmenopausal osteoporosis patients with knee osteoarthritis were in OPA group, and 76 patients with knee osteoarthritis were in KOA group. The levels of serum osteocalcin (BGP), tartrate acid phosphatase allogeneic (TRACP-5b), bone alkaline phosphatase (BAP), type I collagen cross-linked C-terminal peptide (CTX-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1), interleukin-10 (IL-10), and BMD of the left hip and anteroposterior lumbar spine 1-4 (L1-4) were observed and analyzed. Results The levels of serum BGP, TRACP-5b, BAP, BGP, and CTX-1 in OPA group were higher than those in OP group (P<0.05), while those in KOA group were lower than in OP group (P<0.05). The serum level of TGF-β1 in KOA group were higher than that in OP group (P<0.05), while the levels of serum IL-6, TNF-α, and IL-10 were significantly lower than those in OP group (P<0.05). The levels of serum IL-6, IL-10, and TNF-α in KOA group were higher than those in the OP group (P<0.05), while the level of TGF-β1 was lower than that in the OP group (P<0.05). BMD of L1-4 and left hip in OP group and OPA group was significantly lower than that in KOA group (P<0.05). Conclusion BMD and bone metabolism in postmenopausal osteoporotic patients with knee osteoarthritis reduce to varying degrees and cytokine levels elevate. The immune abnormalities need to be addressed during treatment.
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