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| 长期华法林治疗对骨代谢指标及骨密度的影响 |
| Effect of long-term warfarin therapy on bone metabolic markers and bone mineral density in the patients |
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| DOI：10.3969/j.issn.1006-7108.2019.12.024 |
| 中文关键词: 华法林 骨密度 骨代谢 骨钙素 维生素K拮抗剂 |
| 英文关键词:warfarin bone mineral density bone metabolism osteocalcin vitamin K antagonists |
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| 中文摘要: |
| 目的 观察长期华法林治疗对患者骨代谢指标和骨密度（bone mineral density, BMD）的影响。方法 对长期服用华法林的42名患者和28名对照组人群进行横断面研究。使用酶联免疫吸附测定(ELISA)试剂盒测量骨钙素(osteocalcin ,OC)，骨保护素(osteoprotegerin ,OPG)和核因子-κB配体(RANKL)总可溶性受体激活剂的血清水平，并通过双能X射线吸收测定法评估受试者股骨颈和腰椎BMD。结果 与对照组相比，华法林患者的OC浓度显著降低[(4.94±2.22) vs (10.68±4.5)，P <0.001)]。OPG、sRANKL对数(log)、sRANKL/OPG对数比和BMD的水平相当。在女性华法林使用者中，发现OC和RANKL对数之间以及OC和RANKL/OPG对数比之间呈正相关(分别为P = 0.017；P = 0.005)、OC和OPG之间呈负相关(P= 0.027)。结论 长期华法林抗凝治疗可显著降低OC水平，但不影响其它骨代谢指标或BMD。此次研究结果还表明，长期使用华法林治疗可能会减轻绝经后妇女的骨吸收。 |
| 英文摘要: |
| Objective To observe the effect of long-term warfarin therapy on bone metabolic markers and bone mineral density (BMD) in the patients. Methods The cross-sectional study was carried out in 42 patients treated with long-term warfarin and 28 control subjects. Serum concentrations of osteocalcin (OC), osteoprotegerin (OPG), and total soluble receptor activator of nuclear factor- κB ligand (RANKL) were measured using enzyme linked immunosorbent assay (ELISA) kits. BMD of the femoral neck and lumbar spine was assessed with dual energy X-ray absorptiometry. Results A significantly decreased concentration of OC was found in warfarin users compared to control subjects [(4.94 ± 2.22) vs (10.68 ± 4.5), P<0.001)]. Levels of OPG, sRANKL logarithm (log), sRANKL/OPG log ratio, and BMD were consistent. In female warfarin users, positive correlations between OC and RANKL log and between OC and RANKL/OPG log ratio ( P = 0.017; P = 0.005, respectively), and a negative correlation between OC and OPG (P= 0.027) were found. Conclusion Long-term warfarin anticoagulation significantly decreases OC concentration, but does not affect other bone metabolic markers or BMD. Our results also suggest the possibility that long-term treatment with warfarin may alleviate bone resorption in postmenopausal women. |
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