骨源性碱性磷酸酶对类风湿关节炎患者骨质疏松的临床意义

The Clinical Significance of Bone Alkaline Phosphatase in Rheumatoid Arthritis Patients with Osteoporosis

目的 探讨骨源性碱性磷酸酶 (BAP)对类风湿关节炎 (RA)患者骨质疏松的诊断价值。方法 对 6 4例女性RA患者和 6 0例健康女性进行血钙 (Ca)、血磷 (P)、血碱性磷酸酶 (ALP)、血BAP及股骨颈骨密度 (BMD)测定。结果 行经期RA患者的BAP比行经期正常对照组 ( 175.76± 8.0 6 μ L比 150 .37± 1.6 3μ L) ,绝经期RA患者的BAP比绝经期正常对照组 ( 182 .33±6 .4 4μ L比 16 0 .90± 1.6 5μ L) ,均显著升高 (P均 <0 .0 5)。行经期RA患者的股骨颈BMD比行经期正常对照组 ( 0 .84± 0 .12g cm2 比0 .99± 0 .15g cm2 ) ,绝经期RA患者的股骨颈BMD比绝经期正常对照组 ( 0 .6 7± 0 .14 g cm2 比 0 .83± 0 .11g cm2 ) ,均显著降低 (P<0 .0 5)。行经期及绝经期RA患者与正常对照组血Ca、P、ALP比较差异无显著性 (P >0 .0 5)。结论 BAP测定比Ca、P、ALP灵敏 ,比BMD经济方便 ,因此 。

Objective To investigate the diagnostic value of bone alkaline phosphatase (BAP) in rheumatoid arthritis (RA) patients with osteoporosis. Methods Blood Calcium (Ca), Phosphorus (P), alkaline phosphatase (ALP),BAP and neck of femur boned mineral density (BMD) have been measured in 64 female patients with RA and 60 normal women.Results Compared with normal persons, BAP increased significantly in RA patients of menstrual period (175.76 ± 8.06μ/L Vs 150.37 ± 1.63μ/L), and climacteric(182.33 ± 6.44 μ/L Vs 160.90 ± 1.65μ/L), ( P < 0.05 respectively). Compared with normal persons, neck of femur BMD decreased significantly in RA patients of menstrual period(0.84 ± 0.12g/cm 2 Vs 0.99 ± 0.15g/cm 2), and climacteric(0.67 ± 0.14g/cm 2 Vs 0.83 ± 0.1 lg/cm 2 ) ( P < 0.05 respectively). No significantly difference was noted between RA patients and normal persons in Ca, P, ALP( P > 0.05 ). Conclusion BAP is more sensitive than Ca, P,and ALP, it is more convenient and economical than BMD. BAP is a diagnostic index in RA patients with osteoporosis.