老年人髋部骨折骨代谢生化指标测定

摘要

目的通过测定骨代谢生化指标，更好地预测老年髋部骨折发生的危险性。方法对32例（男14例，女18例）60岁以上髋部骨折患者和30例（男15例，女15例）老年健康对照组进行尿Ⅰ型胶原羟基末端肽(type Ⅰcollagen crosslinked c-telopeptide, CrosslapsTM)、脱氧吡啶啉(deoxypyridinoline, Dpd)和血清骨钙素(osteocalcin, OC 或bone gla protein, BGP)测定。结果 (1)老年髋部骨折患者尿中CrosslapsTM和Dpd水平均高于对照组(P<0.01和P<0.001)，且对照组女性高于对照组男性，测定效果Dpd优于CrosslapsTM。(2)老年髋部骨折患者，骨折后1个月Dpd变化不大。(3)老年髋部骨折组与对照组比较，血清BGP水平差异无显著性意义（P>0.05）。结论老年髋部骨折患者骨吸收高于同年龄组健康人。尿中反映骨吸收指标CrosslapsTM和Dpd的监测对老年髋部骨折的预防和治疗有一定的参考价值。%Objective　To observe the bone turnover rate of the aged patients with hip fracture by the biochemical maker for prediction of the risk of future fracture.　Methods　Thirty-two patients (over 60 years) with hip fracture (14 males and 18 females) and 30 healthy persons (15 males and 15 females) were selected for analyzing crosslapsTM, deoxypyridinoline(Dpd) in urine,and osteocalcin (OC or BGP) in serum.　Results　(1)The mean urine level of crosslapsTM, Dpd in hip fracture group was significantly higher than that of control groups (P<0.01,P<0.001 respectively), and Dpd was better than crosslapsTM. The marker of female was higher than that of male in control groups.(2) One month after fracture, there was no obvious change for Dpd.(3)The mean serum level of BGP in hip fracture was not obviously different with control groups (P>0.05).　Conclusions　Bone resorbtion in the aged patients with hip fracture was higher than the other same old healthy persons. It is suggested that the analysis of Dpd and crosslapsTM in urine may provide some reference value for the prevention and treatment of the aged patients with hip fracture.