血尿Ⅰ型胶原交联C端肽和Ⅰ型胶原交联N端肽在骨关节结核转移的研究

Research of CTX and NTX of hematuresis in osteoarticular tuberculosis with metastasis

目的探讨骨关节结核患者血尿Ⅰ型胶原交联C端肽(CTX)和Ⅰ型胶原交联N端肽(NTX)变化水平与结核杆菌骨关节转移程度的相关性。方法选取健康体检人群、肺结核患者和骨关节结核患者各60例,测定三组人群血尿CTX、NTX的含量及血清中骨源性碱性磷酸酶(BALP)、Ⅰ型前胶原C-末端前肽(PICP)、Ⅰ型前胶原N-末端前肽(PINP)变化水平。对比观察三组人群血尿CTX、NTX的含量,血清BALP、PICP、PINP水平,血CTX、NTX和尿CTX、NTX与抗结核治疗效果的相关性。结果骨关节结核组的血CTX、NTX和尿NTX的含量与健康对照组比较均明显增高,差异有统计学意义(P<0.05),而三组间尿CTX含量差异无统计学意义(P>0.05);骨关节结核患者血清中PICP、PINP明显低于健康对照组,差异有统计学意义(P<0.05),三组间血清BALP差异无统计学意义(P>0.05);血CTX、NTX和尿NTX、CTX与抗结核治疗效果均呈明显正相关(P<0.05)。结论骨关节结核组患者血CTX、NTX和尿NTX含量明显高于健康对照组,在排除骨质疏松症和骨肿瘤等破坏性骨相关疾病的肺结核患者早期检测血尿CTX、NTX含量可作为预测骨关节结核转移的重要参考指标。

Objective To explore con＇elation between the change levels of crosslinked C telopeptide （CTX） and Ntelopeptide （NTX） of Type I collagen in the blood and urine and the bone-metastasis degree of mycobacterium tuberculosis among patients with osteoarticular tuberculosis.Methods Healthy controls（ n = 60） from check-up centres,patients with pulmonaiy tuberculosis （n = 60） ,and patients with osteoarticular tuberculosis （n = 60） were selected in the study.The levels of CTX and NTX of hematuresis and the serum levels of the bone alkaline phosphatase （ BALP） and CTX of type I procollagen and NTX of type I procollagen（ PINP） among the three groups were tested.In addition, content of CTX and NTX of hematuresis,serum levels of BALP,PICP and PINP as well as con＇elation between CTX and NTX in blood and those in urine and effect of anti tuberculosis treatment were compared and obsen^ed. Results The serum CTX and NTX levels and urine NTX levels among cases with osteoarticular tuberculosis were significantly higher than those of the healthy controls, difference was statistically significant（ P〈0.05） ,but difference of content of urine CTX among the three groups was not statistically signifi- cant（ P〉0.05） . Serum levels of PICP and PINP among cases with osteoarticular tuberculosis were significantly lower than those of the healthy controls,difference was statistically significant（P〈0.05） .However,difference of serum levels of BALP among the three groups was not statistically significant（ P〉0.05） .In addition, both CTX and NTX in blood and in urine were positively associated with effects of anti tuberculosis treatment（ P〈0.05） .Conclusion The content of CTX and NTX in blood and NTX in urine among cases with osteoarticular tuberculosis are obviously higher than those of the healthy controls, sugges-ting that early detection of levels of CTX and NTX in serum and urine might be regarded as significantly important reference index for the metastasis of osteoarticular tuberculosis excluding destructive bone related diseases such as osteoporosis and bone tumors, etc,.