老年糖尿病骨质疏松性骨折患者血清生化指标的检测研究

Detection of serum biochemical indexes in elderly patients with type2 diabetes mellitus with osteoporotic fracture

目的:研究老年2型糖尿病骨质疏松性骨折患者血清生化指标,为临床诊治提供参考。方法:回顾性分析我院于2014年12月至2017年12月期间收治的老年2型糖尿病骨质疏松性骨折患者154例,另选取同期收治的老年2型糖尿病骨折疏松症组166例,老年2型糖尿病组192例,健康体检者120例。对比4组血清生化指标变化,并按性别、年龄分层,对比不同年龄及不同性别患者血清生化指标变化。结果:4组相比,2型糖尿病组血清1型胶原蛋白C末端交联肽(type 1collagen protein C-terminal crosslinking peptide,CTX)、1型前胶原氨基末端前肽(procollagen 1Nterminal peptide,P1NP)、血清碱性磷酸酶(serum alkaline phosphatase,ALP)及骨钙素(osteo calcin,OC)水平低于骨折组、骨折疏松症组,对照组血清CTX、P1NP、ALP及OC水平低于其余3组,差异均有统计学意义(P<0.05),但骨折组、骨折疏松症组间对比无差异(P>0.05)。骨折组、骨折疏松症组及2型糖尿病组男性患者血清CTX、P1NP、ALP及OC水平均低于女性(P<0.05),且对照组不同性别患者上述指标差异不明显(P>0.05)。骨折组、骨折疏松症组、2型糖尿病组及对照组年龄<60岁血清CTX、P1NP、ALP及OC水平均低于年龄≥60岁组(P<0.05)。结论:老年2型糖尿病骨质疏松性骨折患者血清骨标志物CTX、P1NP、ALP及OC水平升高明显,且随病情加重而升高,值得临床借鉴。

Objective：To study the serum biochemical indexes in elderly patients with type 2 diabetes mellitus with osteoporotic fracture so as to provide reference for clinical diagnosis and treatment.Methods：154 senile type 2 diabetic patients with osteoporotic fractures in our hospital from December 2014 to December 2017 were selected as the observation group subjects and retrospectively analyzed.During the same period,senile type 2 diabetic osteoporosis fracture group of 166 cases,senile type 2 diabetes mellitus group of 192 cases,healthy persons group of 120 cases were also analyzed.The changes of serum biochemical indexes in the four groups were compared,and the changes of serum biochemical indexes in different age and gender patients were compared according to gender and age.Results：Four groups were compared;serum CTX,P1 NP,ALP and OC in the type 2 diabetes group were lower than those of fracture group and osteoporosis fracture group.In control group,serum CTX,P1 NP,ALP and OC were lower than those of the other three groups,the differences were statistically significant（P〈0.05）,but there was no difference between the fracture group and the osteoporosis fracture group（P〈0.05）.In terms of gender,the serum CTX,P1 NP,ALP and OC levels of male patients in fracture group,osteoporotic fracture group and type 2 diabetes group were lower than those in female patients（P〈0.05）,and there was no significant difference in the above indexes among patients of different genders in the control group（P〈0.05）.In terms of age,serum CTX,P1 NP,ALP and OC levels of60 years old patients in fracture group,osteoporosis fracture group,type 2 diabetes group and control group were all lower than those of≥60 years old patients（P〈0.05）.Conclusion：The serum markers of bone CTX,P1 NP,ALP and OC in elderly patients with type 2 diabetes mellitus osteoporotic fracture increased significantly,and increased with the severity of the disease,which is worthy of clinical reference.