骨代谢指标测定在骨质疏松诊治中的应用价值

THE VALUE OF DETERMINATION OF METABOLIC INDICES OF BONE IN DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS

目的比较妇女绝经前后骨代谢指标的变化,研究各指标在骨质疏松症治疗后的变化率,对各指标在骨质疏松症诊治中的应用作出初步评价。方法48例绝经前妇女、48例绝经后妇女测定10项骨代谢指标,45例绝经后骨质疏松症患者,治疗前、治疗6个月后分别测定10项骨代谢指标,观察其变化率。12名绝经后妇女,每两个月测定10项骨代谢指标,共观察一年。结果绝经后妇女骨代谢指标明显升高,绝经后骨质疏松症患者经抗吸收治疗后,大部分骨代谢指标明显降低,血清骨形成指标比尿骨吸收指标长期个体内的变异要小。结论绝经后骨质疏松症患者骨转换加快,部分血清骨代谢指标优于尿骨代谢指标,尤以血清骨形成指标N-mid骨钙素和血清骨吸收指标CTX为优。

Objective To compare the changes of bone metabolic indices in pre-menopausal and post-menopausal women and to study the change rate of different indices after treatment of osteoporosis. To observe the individual′s spontaneous-variation of the ten indices of bone metabolism. To make a preliminary assess of application of different indices in the diagnosis and treatment of osteoporosis. Methods The bone metabolic indices were determined in 48 premenopausal women and 48 post-menopausal women. The ten bone metabolic indices were also determined in 45 cases of post-menopausal osteoporosis patients before and after treatment to observe the change rate. The ten indices of bone metabolism in 12 post-menopausal women were determined every 2 months for one year. Results Bone metabolic indices in post-menopausal women were markedly elevated. while in post-menopausal osteoporotic patients after antiresorptive treatment, major parts of bone metabolic indices were markedly decreased. Serum osteoformation indices, in comparing to urinary bone absorption indices, had a less longterm variation in the individual body. Conclusions The indices of bone turnover appear to be useful in assessing response to therapy. Serum bone metabolic indices, especially serum N-MIN BGP and CTx, are better indicators for estimating the response to therapy.