骨质疏松患者骨碱性磷酸酶、钙、磷代谢变化及与牙槽骨骨密度的相关性

摘要

目的 探究骨质疏松患者血清钙、磷、骨碱性磷酸酶代谢变化及其与牙槽骨骨密度的相关性,以期通过血生化指标了解牙槽骨的代谢状况.方法 46例患者随机分为2组,观察组(强骨胶囊组)和对照组(阿仑膦酸钠片组)各23例,药物治疗前采集静脉血进行血清钙、磷、骨碱性磷酸酶水平检测,并行锥形束CT检查,测量牙槽骨骨密度,药物治疗后6月时重复以上检测和检查,观察血清钙、磷、骨碱性磷酸酶变化情况,分析以上血生化指标与牙槽骨骨密度的相关关系.结果 药物治疗前及药物治疗后6月观察组和对照组血清钙、磷及骨碱性磷酸酶变化组间比较均无统计学意义(P＞0.05).药物治疗前及药物治疗后6月观察组和对照组血清钙、磷变化与牙槽骨骨密度无统计学相关性(P＞0.05).药物治疗前观察组和对照组BALP与牙槽骨颊(唇)侧皮质骨骨密度变化呈负相关(r=-0.440,P＜0.05;r=-0.419,P＜0.05),药物治疗后6月两组BALP与牙槽骨颊(唇)侧皮质骨骨密度亦呈负相关(r=-0.642,P＜0.05;r=-0.442,P＜0.05).结论 ①血清BALP与牙槽骨颊(唇)侧皮质骨BMD呈统计学负相关;②强骨胶囊可用以提高合并牙列缺损或缺失的骨质疏松患者牙槽骨骨密度;③血清骨碱性磷酸酶可作为评估合并牙列缺损或缺失的骨质疏松患者牙槽骨颊(唇)侧皮质骨骨密度变化的参考指标.%Objective To explore the metabolic changes of bone alkaline phosphatase,calcium,phosphorus and the correlation between these indexes and bone mineral density of the alveolar bone in patients with osteoporosis,in order to understand the metabolic changes of the alveolar bone through blood biochemical indexes.Methods Forty-six patients were randomly divided into 2 groups,the observation group (strong-bone capsule treatment group) and the control group (alendronate sodium treatment group),with 23 cases in each group.The venous blood was collected from each patient before the administration and 6 months after the administration,respectively,to detect the serum levels of calcium,phosphorus,and bone alkaline phosphatase.Cone-beam CT was performed to measure bone mineral density of the alveolar bone.The metabolic changes of bone alkaline phosphatase,calcium,and phosphorus were observed.The correlation between these indexes and bone mineral density of the alveolar bone was analyzed.Results The serum calcium,phosphorus,and bone alkaline phosphate were not statistically different between the observation group and the control group before and 6 months after the administration (P ＞ 0.05).Serum calcium and phosphorus were not correlated with bone mineral density of the alveolar bone in both groups before and 6 months after the administration (P ＞ 0.05).Before the administration,serum bone alkaline phosphatase was negatively correlated with bone mineral density of the buccal (labial) region of the alveolar cortical bone in both groups (r =-0.440,P ＜ 0.05;r =-0.419,P ＜ 0.05).At 6 months after the administration,serum bone alkaline phosphatase was also negatively correlated with bone mineral density of the buccal (labial) region of the alveolar cortical bone in both groups (r =-0.642,P ＜ 0.05;r =-0.442,P ＜ 0.05).Conclusion 1) Serum bone alkaline phosphatase is negatively correlated with bone mineral density of the buccal (labial) region of the alveolar cortical bone.2)Strong-bone capsule can be used to enhance bone mineral density of the alveolar bone in osteoporosis patients with dentition defect or edentulous jaw.3) Serum bone alkaline phosphatase can be used as a referential index for evaluation of the change in bone mineral density of the buccal (labial) region in the alveolar cortical bone for osteoporosis patients with dentition defect or edentulous jaw.