血清学骨转化指标在诊断老年女性骨质疏松症中的作用

Clinical significance of serum bone turnover indicators in diagnosis of elderly women with osteoporosis

目的探讨血清学中的骨转化指标骨特异性碱性磷酸酶（B-ALP）、骨钙素（BGP）、抗酒石酸酸性磷酸酶5b（TRAcP5b）和甲状旁腺激素（PTH）在老年女性骨质疏松症诊断中的作用。方法128例老年女性骨质疏松症患者，根据骨质疏松程度分为三组，骨量减少组（46例）、骨质疏松组（54例）和严重骨质疏松组（28例），选取45例健康体检的老年女性作为对照组。检测各组血清中B-ALP、BGP、TRACP5b和PTH的水平，并测定骨密度。结果骨量减少组、骨质疏松组和严重骨质疏松组患者BGP、B-ALP水平均显著高于对照组[（25．88±10．21）、（21．59±8．67）、（19．15±7．35）μg／L比（9．55±4．05）μg／L和（181．25±11．84）、（186．25±15．84）、（190．38±21．24）U／L比（150．55±10．05）U/L]（P＜0．01或＜0．05）。骨量减少组和骨质疏松组的PTH水平显著高于对照组[（63．79±21．94）、（58．89±12．03）ng／L比（43．66±19．66）ng／L]（P＜0．05）。骨质疏松组和严重骨质疏松组的骨密度显著低于对照组[（0．64±0．25）、（0．61±0．43）g／cm^2比（0．98±0．11）g／cm^2]（P〈0．01）。骨量减少组和严重骨质疏松组的TRACP5b显著高于对照组[（5．48±0．98）、（5．25±1．06）U／L比（2．75±1．35）U/L]（P＜0．01或＜0．05）。结论血清学中的骨转化指标B-ALP、BGP、TRACP5b和PTH有利于辅助诊断老年女性骨质疏松症。

Objective To investigate the clinical significance of serum bone turnover indicators in diagnosis of elderly women with osteoporosis. Methods One hundred and twenty-eight cases of elderly women with osteoporosis were divided into bone loss group （46 cases）,osteoporosis group （54 cases） and severe osteoporosis group （28 cases） according to degree of osteoporosis. Selected physical examination in 45 eases of elderly women as control group. Serum bone-specific alkaline phosphatase （B-ALP）, osteoealcin （BGP）, tartrate resistant acid phosphatase （TRACP5b） and parathyroid hormone （PTH） levels were detected using immunological method, and determination of bone mineral density （BMD）. Results Compared with those of control group, BGP and B-ALP of bone loss group, osteoporosis group and severe osteoporosis group was significantly increased [ （25.88 ± 10.21 ）, （21.59 ± 8.67）, （ 19.15 ± 7.35 ） μ g/L vs. （9.55 ± 4.05 ） μg/L and（ 181.25 ± 11.84）, （ 186.25 ± 15.84）, （ 190.38 ± 21.24） U/L vs. （ 150.55 ± 10.05） U/L] （P 〈 0.01 or 〈 0.05 ）. PTH of bone loss group and osteoporosis group was significantly higher than that of control group [ （63.79 ± 21.94）, （58.89 ± 12.03） ng/L vs. （43.66 ± 19.66） ng/L] （P 〈 0.05）. BMD of osteoporosis group and severe osteoporosis group was significantly less than that of control group [ （0.64 ± 0.25 ）, （0.61±0.43 ） g/cm^2 vs. （0.98 ± 0.11 ） g/cm^2 ] （P 〈 0.01 ）. TRACP5b in bone loss group and severe osteoporosis group was significantly higher than that of control group [ （5.48 ± 0.98 ）, （5.25 ± 1.06） U/L vs. （2.75 ± 1.35 ） U/L）] （P 〈 0.01 or 〈 0.05 ）. Conclusions Serum bone turnover indicators such as B-ALP, BGP,TRACP5b and PTH are effective in auxiliary diagosis of elderly women with osteooorosis.