骨转换生化标志物的临床应用和评估

目的比较妇女绝经前后骨转换生化标志物变化率,研究各指标在各种疾病组的浓度变化,并对临床应用作出初步评价。方法应用酶联免疫测定法或电化学发光免疫法分别测定164名健康成年人和120例患者血清和尿液中10项骨代谢指标。结果绝经后妇女骨代谢指标明显升高;高转换型骨质疏松组与对照组相比骨转换生化标志物的差异有统计学意义;变形性骨炎组和甲状旁腺功能亢进组与对照组比较除Ⅰ型胶原羧基端前肽(PICP)外,骨转换生化标志物的差异有统计学意义;甲状腺功能亢进组和肿瘤骨转移组除PICP和甲状腺激素(PTH)外,与对照组相比差异有统计学意义;风湿性关节炎除吡啶啉(PYD)和脱氧吡啶啉(DPD)与对照组比较差异有统计学意义外,其余差异均无统计学意义。结论各种骨代谢疾病不同程度影响骨转换,PICP应用于临床敏感性较差。

The clinical application and assessment of bone turnover markers

Objective To compare the change of the bone turnover markers level of woman before menopause and postmenopause,and to research the relationship between bone biomarkers and bone metabolic diseases. Methods 10 kinds of bone marker were determined by enzyme immunoassay and electrochemiluminescence immunoassay in serum and urine of 164 healthy controls and 120 patients. Results The levels of bone markers were increased significantly in postmenopausal women.There was significant increase in Paget's and hyperparathyroidism except c-terminal propeptide of type I collagen(PICP).There was significant increase in hyperthyroidism and bone metastasis except PICP and parathyroid hormone(PTH).There was significant increase of pyridium crosslinks(PYD) and deoxypy-ridinoline(DPYD) in rheumarthritis. Conclusions Bone turnover markers are useful to assess bone metabolic diseases.The clinical sensitivity of PICP is low.