骨代谢指标在绝经后妇女骨质疏松诊断中的应用

摘要

目的：探讨骨代谢生化指标血清碱性磷酸酶（ ALP）、甲状旁腺激素（ PTH）、血清骨钙素（ BGP）、25羟维生素D与骨密度（ BMD）的关系。方法选取2014～2015年在我院门诊及住院部检查及治疗的80例绝经后女性，将入选者分为骨量正常组（ n＝40例）、骨质疏松组（ n＝40例）。采用ELISA法测定两组上述各指标并比较两组骨代谢生化指标的变化，并对BMD与各项骨代谢指标进行直线相关分析。结果骨质疏松组绝经女性各部位BMD值均低于骨量正常组（ P＜0.05）；骨质疏松组绝经女性ALP与腰椎（ L1～L4）及股骨的BMD呈负相关（ r分别为－0.326、－0.296、－0.218、－0.016、－0.246、－0.097）；骨质疏松组绝经女性BGP与腰椎（ L1～L4）的BMD呈负相关（ r＝－0.092）；两组血清钙、磷均在正常范围，两组比较无统计学差异（ P＞0.05）；骨质疏松组血清ALP、PTH及BGP水平均高于骨量正常组（ P值均＜0.05）；骨质疏松组25羟维生素D水平低于正常组（ P＜0.05）。结论与骨密度正常组相比，绝经后发生骨质疏松症的女性，其骨形成指标如ALP、PTH和BGP，均有明显增高趋势。%Objective To investigate the relationship of biochemical indices of bone metabolism in serum alkaline phosphatase ( ALP) , parathyroidhormone(PTH),serumosteocalcin(BGP),25-hydroxyvitaminDandbonemineraldensity.Methods 80postmenopausal women in the hospital from 2014 to 2015 were selected.The changes of biochemical factors of bone metabolism between 2 groups were com-pared, and the correlation between BMD and each biochemical factor of bone metabolism was analyzed .Results BMD of each location in the osteoporotic group was significantly lower than that in the normal bone mass group ( P<0.05 );The concentrations of ALP was negative-ly correlated with BMD of the lumbar vertebrae ( L1 ~L4 ) and the femoral neck in postmenopausal women in the osteoporotic group ( r=-0.326 , -0.296 , -0.218 ,-0.016 , -0.246 , -0.097 );The concentrations of BGP was negatively correlated with BMD of the lum-bar vertebrae (L1~L4) and the femoral neck in postmenopausal women in the osteoporotic group (r=-0.092 ) ; Serum calcium and phosphorus were within normal range in both groups , and the difference was insignificant ( P>0.05 );The concentrations of ALP , PTH and BGP in the osteoporosis group were higher than those in the normal bone mass group and the difference was significant ( P<0.05 ); The concentrations of 25-hydroxy vitamin D in the osteoporosis group were lower than those in the normal bone mass group , and the difference was insignificant ( P<0.05 ).Conclusion Formation of postmenopausal osteoporosis in postmenopausal indicators compared with normal bone mineral density in the bone has the increasing trend.