骨转换指标测定在绝经后妇女骨质疏松症诊疗中的临床意义

摘要

目的：研究骨转换指标在绝经后骨质疏松症患者中的变化，探讨骨转换指标测定在绝经后骨质疏松症中的临床应用价值。方法选择90例绝经后妇女为受试对象，包括58例骨质疏松患者，21例正常对照者和11例骨量减低者，采用化学发光法和酶联免疫吸附试验检测血清中骨转换指标。结果正常对照组与骨质疏松组相比PINP（血清I型胶原氨基端前肽）、OC（骨钙素）和Sclerostin均有显著性差异，并与骨密度存在显著相关性；单项指标中OC具有最佳灵敏度和特异性分别为68.7％和72.4％；OC和PINP联合检测具有最佳特异性和阳性预测值（76.5％和88.2％）；OC、PINP和Sclerostin联合检测具有最佳灵敏度和阴性预测值（81.8％和69.2％）。结论骨代谢指标可用于绝经后骨质疏松症的诊断，多指标联合检测可以显著提高检测性能。%Objective To evaluate the clinical significance of bone turnover markers in postmenopausal osteoporosis ,and investigate the clinical application value of these indexes.Methods Chemiluminescence immunoassay and enzyme -linked immunosorbent assay were used to determine bone turnover markers in sera of 90 cases, of which 58 were patients with postmenopausal osteoporosis , 21 healthy con-trols and 11 with bone mass reduction.Results PINP, OC and Sclerostin in patients with postmenopausal osteoporosis showed obvious difference with healthy controls and had significant correlations with bone mineral density ( BMD);among single index OC had the optimal sensitivity and specificity (68.7%and 72.4%, respectively ); the combination of OC and PINP had the optimal specificity and positive predictive value (76.5%and 88.2%, respectively);the combination of OC, PINP and sclerostin had the optimal sensitivity and negative predictive value (81.8%and 69.2%, respectively).Conclusion It was suggested that serum bone turnover markers could be useful tools in identifying postmenopausal osteoporosis.The joint application of BTMs could increase their diagnostic efficiency in the diagnosis of post-menopausal osteoporosis.