绝经后骨质疏松症的防治与某些细胞因子的效因关系

The Effective Relation between Prevention and Treatment of Postmenopausal Osteoporosis and some Cytokine

目的：比较不同治疗方法对绝经后骨质疏松（ＰＭＯ）患者血清白细胞介素－１，２，６（ＩＬ—１，２，６），胰岛素样生长因子Ⅱ（ＩＧＦ Ⅱ）及骨密度（ＢＭＤ）的影响，从免疫学角度探讨 ＰＭＯ的防治机制。方法：用放射免疫法测定 ７０例伴有骨疼痛的绝经后低骨量或骨质疏松患者（双阳组）的血清 ＩＬ—１，２，６和 ＩＧＦⅡ，选用单能 Ｘ线吸收测定法测定跟骨骨密度，并与 ３０例骨密度正常，无骨痛的健康绝经后妇女（双阴组）和３０例２５～３０岁健康女性青年（青年组）作对照。双阳组患者分成３组，妊马雌酮（倍美力）组（３０例），妊马雌酮、依屈膦酸二钠片（ＨＥＢＰ）联合治疗组（３０例），对照组（１０例），比较治疗前后上述细胞因子及骨密度的变化。结果：绝经后妇女均有ＩＬ—１，２，６和ＩＧＦⅡ水平上升，ＰＭＯ患者上升幅度较大。治疗后，两组患者的血清ＩＬ－１，２，６和ＩＧＦⅡ有下降趋势。妊马雌酮治疗仅能延缓骨丢失，不能逆转已经存在的低骨量。联合治疗不仅延缓骨丢失，而且使骨量增加，骨密度上升。结论：ＰＭＯ患者的免疫活性细胞释放过多的 ＩＬ—１，２，６和 ＩＧＦⅡ，参与了骨骼系统的免疫损伤。妊马雌酮和 ＨＥＢＰ联合治疗可使 ＩＬ—１，２，６和 ＩＧＦⅡ水平?

Objective: To study the change of interleukin - 1, 2, 6 (IL - 1, 2, 6), Insulin-like growth factor Ⅱ (IGF Ⅱ ) and bone mineral density (BMD) in PMO and to explore the immunologic etiology of treatment and provention in PMO. Methods: The serum levels of IL - 1, 2, 6 and IGF Ⅱ in 70 cases of osteoporosis or low bone mass postmenopausal women companied with bone - ache (double - positive group), and 30 cases of healthy postmenopausal women (double - negative group), and 30 cases healthy young women (young group) were determined with a sensitive radioimmunoassay. BMD of calcaneus were measured by SXA. The double - positive group were divided into 3 treating groups: Premarin group (n = 30), Premarin combined with etidronate disodium tablets (HEBP) group (n = 30) and control group (n = 10). Results: The serum IL - 1, 2, 6 and IGF Ⅱ levels in all postmenopausnl women had a increasing trend. In double - possitive group, IL - 1, 2, 6 and IGF Ⅱ levels were higher than double - negitive group. After treatment, IL - 1, 2, 6 and IGF Ⅱ levels in 2 groups had a decreasing trend as compared with that before treatment. Primarin could delay bone loss, but can' t increase bone mass. Combined therapy could not only delay bone loss but also increase bone mass. Conclution: In PMo, IL - 1, 2, 6 and IGF Ⅱ are overproduced and it may involve in immune damage of skeletal system. This two methods have some therapeutic effects on PMO, Combined therapy appeared to work better.