骨质疏松症患者血清H2S的变化及临床意义

目的 探讨骨质疏松症患者血清硫化氢（H₂S）的变化及临床意义。方法 收集骨质疏松症患者128例作为骨质疏松组,另选取腰背部疼痛但排除骨质疏松的患者110例作为对照组。采用双能X线骨密度仪检测腰椎（L_1~4）和双侧股骨颈骨密度,亚洲人骨质疏松自我筛查工具（OSTA）筛查骨质疏松风险。采集空腹静脉血5 mL,检测血清H₂S、碱性磷酸酶（ALP）、骨特异性碱性磷酸酶（BALP）、血磷、血钙、血清骨钙素、甲状旁腺素（iPTH）、Ⅰ型原胶原N-端前肽（P1NP）、Ⅰ型胶原C-末端肽交联（P1CP）、Ⅰ型胶原羧基端肽β特殊序列（β-CTX）等骨代谢标志物水平。Pearson相关分析骨质疏松症患者血清H₂S与骨代谢标志物的相关性。结果 与对照组相比,骨质疏松组患者腰椎骨密度、股骨颈骨密度、OSTA指数和血清H₂S浓度下降,血清ALP、BALP、骨钙素、P1NP、P1CP、iPTH水平下降,β-CTX水平升高（P<0.05）。骨质疏松症患者血清H₂S与ALP、BALP、血清骨钙素、P1NP、P1CP、iPTH呈正相关,与β-CTX呈负相关（均P<0.05）。结论 骨质疏松症患者血清H₂S水平出现明显下降,检测H₂S有助于评估患者骨代谢水平。

Changes of serum H2S in patients with osteoporosis and its clinical significance

Objective To investigate changes and clinical significance of serum hydrogen sulfide (H₂S) in patients with osteoporosis. Methods A total of 128 patients with osteoporosis admitted to our hospital were used as the osteoporosis group, and another 110 patients with low back pain in our hospital during the same period were selected as the control group. The Asian Osteoporosis Self-screening Tool (OSTA) was used to screen for osteoporosis risk by measuring bone mineral density in the lumbar spine (L_1-4) and bilateral femoral neck with dual energy X-ray spectrometer. Five mL of fasting venous blood was collected from all patients after admission. Serum H₂S, alkaline phosphatase (ALP), bone specific alkaline phosphatase (BALP), serum phosphorus, serum calcium, parathyroid hormone (iPTH), CTX, N-terminal propeptide of type 1 procollagen (P1NP), cross-linking C-terminal peptide of urinary 1 collagen (P1CP) and special sequence of carboxy-terminal peptide of type Ⅰ collagen (β-CTX) were detected. Pearson correlation analysis was conducted to analyze the correlation between serum H₂S and bone metabolic markers in patients with osteoporosis. Results Compared with the control group, the bone mineral density of lumbar vertebra and femoral neck decreased, the serum H₂S concentration decreased, the serum ALP, BALP, serum osteocalcin, P1NP, P1CP and iPTH concentration decreased, and the β-CTX level increased in the osteoporosis group (P<0.05). Serum H₂S was positively correlated with ALP, BALP, serum osteocalcin, P1NP, P1CP and iPTH in patients with osteoporosis, but negatively correlated with β-CTX (P<0.05). Conclusion The serum level of H₂S is significantly decreased in patients with osteoporosis. The detection of H₂S is helpful to evaluate the bone metabolism in patients.