骨代谢生化指标在评价绝经后女性骨质疏松治疗中的应用

摘要

Objective To explore the application of new biochemical indexes of bone metabolism in the diagnosis, monitoring and theraphy of postmenopausal women with osteoporosis. Methods Fifty-six cases of postmenopausal women with type 2 diabetes complicated with osteoporosis were randomly divided into 2 groups:treatment group ( 28 cases ) and control group ( 28 cases ). The experimental group were treated with Fosamax 10mg/d for 6 months and control group with placebo. Bone minernal density ( BMD ) of lumbar vertebrae and ilitum, procollagen type Ⅰ aminoterminal peptide ( TP1NP ), Crossl procollagen type Ⅰ carboxyterminal peptide ( β-Crosslaps ), Ca, phosphorus and ALP were tested. Results BMD was increased in the treatment group at the lumbar spine and femoral neck by 11.23％, 17.1％ ( P＜O.05 ), respectively. TP1NP and β-crosslaps were declined in treatment group, Ca, phosphorus and ALP were not differ obviously. Conclusion The results suggested TP1NP and β-Crosslaps affiliated with BMD could discover osteoporosis,and TP1NP and β-Crosslaps were play a important role in diagnosis and therapy of osteoporosis.%目的:探讨骨代谢生化指标在绝经后妇女并发骨质疏松的早期诊断和治疗后监测中的应用.方法:临床收集绝经后的女性糖尿病患者56例,合并有骨质疏松,随机分为药物干预组和未治疗组各28例,药物干预组服用二磷酸盐类药物(阿仑膦酸钠)10mg,1片/d;对照组;给予安慰剂,连续观察6个月,分别测定药物干预前后的腰椎、股骨颈骨密度(BMD)、总I型前胶原氨基端延长肽(TP1NP)、Ⅰ型胶原羧基末端肽(β-Crosslaps),血清钙、磷及碱性磷酸酶(ALP),并进行对比分析.结果:治疗组腰椎BMD和股骨颈BMD较治疗前分别提高11.23%、17.1%,与对照组差异有统计学意义(P＜0.05);治疗组患者给药后血TP1NP、β-Crosslaps显著低于给药前,对照组其值未见明显变化,两组差异有统计学意义(P＜0.05);治疗组和对照组血清钙、磷、ALP在治疗前后均未见明显变化,两组差异无统计学意义(P＞0.05).结论:血清TP1NP、β-Crosslaps结合骨密度可有效观察患者骨质疏松的病程变化,血清TP1NP、β-Crosslaps可早期发现骨质改变,对较早诊断骨质疏松和评价药物治疗效果起到关键作用.