目的检测代谢性骨病患者跟骨骨密度(bone mineral density,BMD)与四种骨吸收标志物抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatasey,TRAP)、脱氧吡啶酚(deoxy pyridinoline,D-Pyr)、Ⅰ型胶原N端肽(N-telope tide of typeⅠcol...目的检测代谢性骨病患者跟骨骨密度(bone mineral density,BMD)与四种骨吸收标志物抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatasey,TRAP)、脱氧吡啶酚(deoxy pyridinoline,D-Pyr)、Ⅰ型胶原N端肽(N-telope tide of typeⅠcollagen,NTX)、尿羟脯氨酸(hydroxyproline,HOP)水平,探讨其相关性。方法采用定量超声法、酶联免疫法、氯氨T化学法测定82例代谢性骨病患者跟骨BMD T值、Z值以及血清TRAP、尿D-Pyr/Cr、尿NTX/Cr、尿HOP/Cr水平,多元回归分析其相关性,并以85例健康人群作对照组。结果代谢性骨病患者跟骨BMD T值、Z值、骨硬度指数下降(P<0.05),男女性T值与年龄负相关,与体质量正相关(P<0.05),而与身高、BMI相关关系不大;患病组血清TRAP、尿D-Pyr/Cr、尿NTX/Cr、尿HOP/Cr水平升高(P<0.05),男性BMD除Z值与TRAP外,T值、Z值均与TRAP、D-Pyr/Cr、NTX/Cr、HOP/Cr负相关(P<0.05),女性T值、Z值与D-Pyr/Cr、NTX/Cr负相关(P<0.05)。结论代谢性骨病患者跟骨BMD下降,骨吸收标志物TRAP、D-PYR、NTX、HOP水平升高,两者存在一定相关性,联合检测可较准确评估患者的骨量变化及病情程度。展开更多
Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secr...Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secreted by osteoclasts,its activity can be used as a clinically relevant bone resorption marker.The aim of this study was to test whether the measurement of serum levels of TRACP-5b in patients with RA would correlate with measures of disease activity and with responses to therapy.Methods Fifty-six patients were randomly assigned to receive recombinant human cytotoxic tlymphocyte-associated antigen-4 immunoglobulin （RhCTLA4-lg）,infliximab or methotrexate （MTX）.The clinical and serologic indicators of RA activity were evaluated at baseline and at 24 weeks.Serum TRACP-5b was measured by Enzyme-linked Immunosorbent Assay （ELISA） at 0,12 and 24 weeks.Hand X-rays were obtained at baseline.Results At baseline,the levels of TRACP-5b correlated with the severity of X-ray damage,disease duration （r=0.332,P=0.012）,and tender joint count （r=0.408,P=0.002）.The 24 weeks values of TRACP-5b for RhCTLA4-lg group and infliximab group differed significantly from the baseline values in each group （P 〈0.05; P 〈0.05）,whereas only the value for RhCTLA4-lg group differed significantly from the 24 weeks value for the MTX group （P 〈0.01）.Considering the two biologics-treated groups together,the TRACP-5b levels at 24 weeks differed significantly from the baseline values only in those patients who reached an ACR70 level （P 〈0.05）.Conclusions Measurement of serum TRACP-5b in RA patients reflects clinical and radiological measures of disease activity,treatment with certain biologics,and degree of response to therapy.TRACP-5b should be investigated further as a potential biomarker to predict response to therapy,including slowing of radiographic progression.展开更多
文摘Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secreted by osteoclasts,its activity can be used as a clinically relevant bone resorption marker.The aim of this study was to test whether the measurement of serum levels of TRACP-5b in patients with RA would correlate with measures of disease activity and with responses to therapy.Methods Fifty-six patients were randomly assigned to receive recombinant human cytotoxic tlymphocyte-associated antigen-4 immunoglobulin （RhCTLA4-lg）,infliximab or methotrexate （MTX）.The clinical and serologic indicators of RA activity were evaluated at baseline and at 24 weeks.Serum TRACP-5b was measured by Enzyme-linked Immunosorbent Assay （ELISA） at 0,12 and 24 weeks.Hand X-rays were obtained at baseline.Results At baseline,the levels of TRACP-5b correlated with the severity of X-ray damage,disease duration （r=0.332,P=0.012）,and tender joint count （r=0.408,P=0.002）.The 24 weeks values of TRACP-5b for RhCTLA4-lg group and infliximab group differed significantly from the baseline values in each group （P 〈0.05; P 〈0.05）,whereas only the value for RhCTLA4-lg group differed significantly from the 24 weeks value for the MTX group （P 〈0.01）.Considering the two biologics-treated groups together,the TRACP-5b levels at 24 weeks differed significantly from the baseline values only in those patients who reached an ACR70 level （P 〈0.05）.Conclusions Measurement of serum TRACP-5b in RA patients reflects clinical and radiological measures of disease activity,treatment with certain biologics,and degree of response to therapy.TRACP-5b should be investigated further as a potential biomarker to predict response to therapy,including slowing of radiographic progression.
