BALP、PTH、IGF-1联合检测在肾性骨病诊断中的应用价值

Application value of combined detection of BALP,PTH and IGF-1 in the diagnosis of renal osteodystrophy

目的探讨骨碱性磷酸酶(BALP)、甲状旁腺激素(PTH)、胰岛素样生长因子-1(IGF-1)联合检测在肾性骨病(ROD)诊断中的应用价值。方法选择2020年1月至2022年12月就诊于本院的90例ROD患者纳入ROD组,另选取同期本院90例健康体检者纳入对照组。两组均接受血清学指标及骨密度检测,比较两组的检测结果,分析血清学指标与骨密度的相关性,探究BALP、PTH、IGF-1单独及联合检测对ROD的诊断效能。结果ROD组的BALP、PTH水平高于对照组,IGF-1水平以及腰椎、股骨近端骨密度低于对照组,差异具有统计学意义(P<0.05)。经Pearson相关性分析,ROD组的BALP、PTH水平与骨密度呈负相关,IGF-1水平与骨密度呈正相关(r=-0.651、-0.553、0.467,P<0.001)。联合检测诊断ROD的灵敏度、特异度、阴性预测值及准确度高于BALP、PTH、IGF-1单独检测,阳性预测值高于BALP、PTH单独检测,差异具有统计学意义(P<0.05)。结论ROD患者与健康人群的BALP、PTH、IGF-1水平存在显著差异,ROD患者的BALP、PTH、IGF-1水平与骨密度存在密切关系,联合检测能够提高ROD的诊断效能,临床可将其用于ROD的辅助诊断。

Objective To explore the application value of combined detection of bone alkaline phosphatase(BALP),parathyroid hormone(PTH)and insulin-like growth factor-1(IGF-1)in the diagnosis of renal osteodystrophy(ROD).Methods A total of 90 patients with ROD who were admitted in our hospital from January 2020 to December 2022 were selected as ROD group,and 90 healthy subjects who underwent physical examination in our hospital during the same period were selected as control group.Both groups received serological indicators and bone mineral density tests.The test results of the two groups were compared,the correlation between serological indicators and bone mineral density was analyzed,and the diagnostic efficacy of BALP,PTH,and IGF-1 alone and in combination for ROD was explored.Results The levels of BALP and PTH in the ROD group were higher than those in the control group,and the IGF-1 level,bone mineral density of lumbar spine and proximal femur were lower than those in the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the levels of BALP and PTH in the ROD group were negatively correlated with bone mineral density,and the level of IGF-1 was positively correlated with bone mineral density(r=-0.651,-0.553,0.467,P<0.001).The sensitivity,specificity,negative predictive value and accuracy of combined detection in the diagnosis of ROD were higher than those of BALP,PTH and IGF-1 alone,and the positive predictive value was higher than that of BALP and PTH alone,and the differences were statistically significant(P<0.05).Conclusion There are significant differences in the levels of BALP,PTH and IGF-1 between ROD patients and healthy people,the levels of BALP,PTH and IGF-1 in ROD patients are closely related to bone mineral density,and combined detection can improve the diagnostic efficiency of ROD,which can be used in the auxiliary diagnosis of ROD.