骨代谢标志物在云克治疗绝经后骨质疏松症中的应用价值

The Application of Bone Metabolic Markers in the Treatment of Postmenopausal Osteoporosis with YunKe

目的:探讨血清总骨Ⅰ型前胶原氨基端延长肽(Total-P1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)监测在云克治疗绝经后骨质疏松症(PMOP)早期疗效中的应用价值。方法:收集来我院就诊的PMOP的患者60例,随机分为云克组30例和对照组30例,检测治疗前及治疗后3、6个月患者的血清Total-P1NP、β-CTX及腰椎和股骨颈骨密度(BMD),同时随访患者疼痛改善情况进行比较分析。结果:云克组和对照组Total-P1NP、β-CTX治疗前后均有不同程度的下降,云克组β-CTX治疗后第3、6个月较治疗前显著降低37.86%、50.19%,Total-P1NP在治疗后第3、6个月降低18.52%、31.41%,且β-CTX变化率明显高于Total-P1NP变化率(P<0.05)。第3、6个月腰椎、股骨颈BMD未见明显差异,治疗后1年BMD出现显著性差异(P<0.05),治疗后3、6个月疼痛缓解率差异有统计学意义;对照组在骨代谢标志物、骨密度、疼痛缓解率方面,治疗前、治疗后3、6个月比较均无明显统计学差异。结论:β-CTX和Total-P1NP测定在早期发现云克PMOP疗效方面早于骨密度法,是骨密度法的有益补充。

Objective:To investigate the clinical value of serum total procollagen type 1 amino terminal propeptide(total P1 NP),cross-linked C-terminal telopeptide of type I collagen(β-CTX)with Yunke in the treatment of postmenopausal osteoporosis(PMOP).Methods:60 cases of PMOP patients in our hospital randomly divided into the Yunke group(30 cases)and control group(30 cases),were measured before treatment and after treatment for 3 and 6 months in patients with serum Total-P1 NP,β-CTX and lumbar spine and femoral neck bone density(BMD),follow-up of patients with pain to improve the situation for analysis and comparison.Results:Total-P1 NP andβ-CTX in Yunke group and control group decreased in varying degrees before and after treatment.In Yunke group,β-CTX decreased by 37.86%,50.19%,in the 3 rd and 6 th month after treatment,and Total-P1 NP decreased by 18.52%,31.41%in the 3 rd and 6 th month after treatment,and the change rate of β-CTX was significantly higher than that of Total-P1 NP(P<0.05).The serum levels of Total-P1 NP andβ-CTX were significantly lower in Yunke group than in the control group(P<0.05).But the two groups showed no significant difference in lumbar or total hip BMD after treatment 3,6 months.one year after Yunke group treatment,the BMD appeared significant difference(P<0.05),control group in bone metabolism markers,bone mineral density(BMD),pain relief rate showed no significant difference.Conclusion:In investigation elderly effect of PMOP patients in treatment with Yunke serumβ-CTX and Total P1 NP was superior to BMD,which was the beneficial supplement of bone mineral density method.