不同肾虚证型的绝经后骨质疏松骨代谢标志物相关性研究

Study on the Correlation of Bone Metabolic Markers in Different Kidney Deficiency Syndrome Types of Postmenopausal Osteoporosis

目的:通过对不同肾虚证型绝经后骨质疏松症患者的血清指标进行分析,探索不同证型之间的血清学差异,为绝经后骨质疏松症患者的中医证型分析提供客观依据。方法:选取2021年2月至2022年1月,年龄为45~80岁,符合肝肾阴虚及肾阳虚两个证型的绝经后骨质疏松症患者,记录其骨密度、一般临床特征及骨代谢标志物,比较不同证型的各指标之间的差异。结果:肾阳虚证组53例,肝肾阴虚证组40例。经年龄与体重指数一比一配对统计学分析,发现肾阳虚证组患者β-CTX水平明显高于肝肾阴虚证组(P<0.05),肝肾阴虚证组患者血清甲状旁腺激素(PTH)水平明显高于肾阳虚证组(P<0.05),差异均有统计学意义。结论:绝经后骨质疏松症中,肾阳虚患者的骨吸收程度可能更高,而肝肾阴虚患者更具有甲状旁腺病理学改变的倾向性。

Objective:To explore the serological differences between different types of evidence and provide an objective basis for the analysis of Chinese medicine evidence in postmenopausal osteoporosis patients by analyzing the serum indexes of postmenopausal osteoporosis patients with different kidney deficiency types.Methods:45-80 years old osteoporosis patients with menopause were selected from February 2021 to January 2022 with two syndrome types of liver-kidney Yin deficiency and kidney Yang deficiency.Bone mineral density(BMD),general clinical features and bone metabolism markers were collected,and the differences of indicators among different syndrome types were compared.Results:Among the 93 patients,53 were in the kidney Yang deficiency syndrome group and 40 were in the liver-kidney Yin deficiency syndrome group.It was found that theβ-CTX level of patients with kidney Yang deficiency was significantly higher than that of the liver-kidney Yin deficiency group after statistical analysis of one-to-one matching of age and body mass index(BMI)(P<O.05),and the serum parathyroid hormone(PTH)level of patients of the liver-kidney Yin deficiency group was signifi-cantly higher than that of the kidney Yang deficiency group(P<o.05),both differences were statistically significant.Con-clusion:In postmenopausal osteoporosis,the level of bone resorption may be higher in patients with kidney Yang deficien-cy,whereas patients with live-kidney Yin deficiency are more predisposed to altered parathyroid pathology.