进行期寻常性银屑病患者皮损面积严重度指数与骨代谢的相关性研究

The correlation between bone metabolism and PASI of progressive psoriasis vulgaris

目的研究进行期寻常性银屑病患者皮损面积严重度指数(PASI)与骨代谢相关指标抗酒石酸酸性磷酸酶5(bTRACP-5b)、血Ca、骨碱性磷酸酶(BAP)、碱性磷酸酶(ALP)的相关性。方法对88例寻常性银屑病进行期患者进行PASI评分并分组,PASI评分≤10分为A组,10～20分为B组,≥20分为C组。采用双能X线吸收法分别检测患者腰椎、股骨颈、左前臂3个部位的骨密度(BMD);在相同条件下检测患者血液中ALP和钙的浓度;ELSIA法检测患者血清中TRACP-5b及BAP的浓度,并进行统计学分析。结果反映骨形成指标的ALP、骨吸收指标的TRACP-5b和血Ca浓度A组和C组差异有统计学意义(P<0.05),成骨细胞活性标志物BAP 3组比较差异无统计学意义(P>0.05)。C组腰椎BMD分别与A、B两组相比差异有统计学意义(P<0.05),A组股骨颈BMD与B、C两组相比差异有统计学意义(P<0.05),而左前臂BMD 3组比较无差异(P>0.05)。C组腰椎、股骨颈峰值骨量(T值)与A、B两组相比差异有统计学意义(P<0.05),3组左前臂T值组间比较无差异(P>0.05)。结论寻常性银屑病进行期患者存在骨代谢异常及骨量流失,且与PASI评分成正比。

Objective To investigate the correlation between PASI scores of progressive psoriasis vulgaris and the bone metabolism markers：TRACP-5b, serum calcium, BAP and ALP. Methods Eighty-eight patients with progressive psoriasis vulgairs were assessed by PASI scoring system, then divided into three groups according to the score：group A （the score ≤ 10）, group B （the score between 10 and 20）, and group C （the score ≥ 20）. The bone density of the patients’ lumbar, femoral neck and left forearm were detected by dual energy x-ray absorptiometry respectively, the concentration of serum ALP and calcium were detected under the same condition, and the concentration of serum TRACP-5b and BAP were detected by ELSIA. Results For the concentration of bone formation markers ALP and bone resorption indicator TRACP-5b and blood calcium, there was signiifcant difference between group A and C （P〈0.05）;for the concentration of the osteoblast markers BAP, there was no signiifcant difference between the every two groups （P〉0.05）;for Lumbar spine BMD, there was signiifcant difference between the group C and the other two groups （P〈0.05）;for femoral neck BMD, there was signiifcant difference between the group A and the other two groups（P〈0.05）;for the left forearm BMD, there was no signiifcant difference between the every two groups （P〈0.05）;for the peak of the bone mass （T-value） of lumbar spine and femoral neck, there was signiifcant difference between group C and the other two groups （P〈0.05）, for the T-value of left forearm, there was no signiifcant difference （P〉0.05） between the every two groups. Conclusion Abnormal bone metabolism and bone loss may occur in the patients with progressive psoriasis vulgaris, and the severity is proportional to the PASI score.