多发性骨髓瘤骨代谢指标的改变

Changes of bone metabolic markers in patients with multiple myeloma

本文测定了１０例多发性骨髓瘤患者的血钙、磷、ＡＫＰ、ＢＧＰ、２４小时尿ＨＯＰ及腰椎２～４正位ＢＭＤ，并且经化疗完全缓解后再次复查。结果（１）多发性骨髓瘤患者血Ｃａ、Ｐ、ＡＫＰ与正常对照无显著差异，化疗前后也无显著差异。（２）血ＢＧＰ低于正常对照，２４小时尿ＨＯＰ高于正常对照，化疗后ＢＧＰ增高，ＨＯＰ下降。（３）ＢＭＤ改变：１０例患者中有３例骨量减低，６例骨质疏松，化疗后ＢＭＤ有所增加。因此，血ＢＧＰ、尿ＨＯＰ和ＢＭＤ对观察多发性骨髓瘤治疗效果有一定的临床指导意义。还初步探讨了破骨细胞因子对骨质破坏的机理。

The levels of serum Ca, P, AKP, BGP,and 24 hour urine HOP and lumbar spine BMD were determined in 10 patients with multiple myeloma (MM). The results demonstrated that the levels of serum Ca,P,AKP were normal before and after chemotherapy of MM. The level of serum BGP in the patients before treatment was lower than that in normal controls ;the level of serum BGP in the patients after treatment increased. The 24 hour urine HOP in the patients before treatment was higher than that in normals while that in the patients after treatment decreased. Of the 10 patients 3 had osteopenia and 6 had osteoporosis. BMD was increased in 9 patients after treatment. The level of serum BGP, 24 hour urine HOP and lumbar spine BMD are useful to evaluate the bone lesions in MM. The mechanism of osteoclastic activating factors(OAF) for osteolysis in patients with MM is discussed.