骨转换生化标志物在骨质疏松症治疗中的临床应用

目的探讨并分析骨转换生化标志物在骨质疏松症治疗中的临床价值。方法将104例骨质疏松症患者随机分成观察组(54例)和对照组(50例)。观察组在治疗前后均进行Ⅰ型胶原蛋白氨基端前胶原肽(PINP)、Ⅰ型胶原分解片段C端肽β型(β-CTx)及骨钙素变化情况的监测,并根据监测结果调整治疗方案,及早预防骨折发生。对照组则根据常规治疗方法进行治疗,不进行骨转换生化标记物监测。治疗结束时通过骨密度检查判定并比较两组的临床治疗效果及骨折发生情况。结果观察组治愈率为88.89%;对照组治愈率66.00%。两组治愈率比较有显著性差异(P<0.05)。观察组治疗结束后骨转换生化指标均处于本地区临床标准范围内。研究期间观察组发生骨折患者3例,占5.56%;对照组发生骨折患者4例,占8.00%,两组比较骨折发生率无显著性差异(P>0.05)。结论骨转换生化指标能敏感反应患者骨形成与骨吸收情况,检测简便且廉价,在骨质疏松症的预防和治疗方面有显著的医疗效益、社会效益和经济效益。

Clinical application of biochemical markers for bone turnover in patients with osteoporosis

Objective To study and analyze the clinical significance of biochemical markers for bone turnover in treatment of patients with osteoporosis.Methods One hundred and four patients with osteoporosis were randomly allocated into observation group（54 cases） and control group（50 cases）.The changes in N-terminal collagen typeⅠprocollagen peptide（PINP）,type I collagen decomposition of C-terminal peptide fragment β-（β-CTx） and osteocalcin were monitored before and after treatment in order to adjust the treatment regimen according to these results and early prevention of fracture.Patients in control group were treated with conventional treatment without monitoring of biochemical markers for bone turnover.Examination for bone mineral density was carried out by the end of treatment course and it was compared between these two groups for determination of clinical efficacy and incidence of fracture.Results In 54 patients of observation group,their mean cure rate was 88.89% and that in control group was 66.00%.There was significant difference in cure rate between these two groups（P0.05）.After treatment,biochemical indicators of bone turnover in patients of observation group were within the range of clinical standards in this region.Fracture had been observed in 3 cases of observation group accounted for 5.56%,and fracture had been occurred in 4 patients of control group accounted for 8.00% There was no significant difference in incidence of fracture between these two groups（P0.05）.Conclusion Bone turnover biochemical markers can sensitively reflect the status of bone formation and resorption in these patients.This kind of detection is simple and cheap and it is important in prevention and treatment of cases of osteoporosis with significant medical benefits,social benefits and economic benefits.