摘要
目的探讨腰椎退变患者骨转换标志物(BTMs)与骨密度(BMD)和脆性骨折风险的相关性。方法选取2016年5月-2017年5月于西部战区总医院骨科治疗的158例腰椎退变患者。采用双能X线测定腰椎BMD;采用罗氏化学发光法测定空腹静脉血Ⅰ型原胶原N末端前肽(PINP)、骨钙素(OC)、骨碱性磷酸酶(BALP)、Ⅰ型胶原C末端肽特殊序列(β-CTX)、25-羟基维生素D[25-(OH)VitD]和抗酒石酸酸性磷酸酶(TRACP)水平;通过询问病史和X线片检查患者既往脆性骨折发生情况;采用多元Logistic回归和线性回归分析患者BTMs与腰椎BMD和脆性骨折风险的相关性。结果158例腰椎退变患者脆性骨折发生率为20.3%,脆性骨折患者腰椎BMD明显低于非脆性骨折患者,PINP、BALP、OC及β-CTX水平明显高于非脆性骨折患者(P<0.05)。PINP、BALP、OC、β-CTX和TRACP与腰椎BMD呈负相关(β依次为–0.431、–0.234、–0.167、–0.314、–0.198,P依次为0.021、0.009、0.034、0.033、0.049)。β-CTX和PINP与脆性骨折风险呈正相关(P<0.05)。结论腰椎退变患者PINP、BALP、OC、β-CTX和TRACP与腰椎BMD呈负相关,β-CTX和PINP与脆性骨折风险呈正相关,提示临床上应早期监测腰椎退变患者BTMs的变化,早期给予抗骨质疏松治疗,降低术后远期螺钉松动和再发骨折的风险。
Objective To investigate the correlation between bone turnover markers(BTMs)with bone mineral density(BMD)and the risk of fragility fracture in patients with lumbar degeneration.Methods One hundred fifty-eight patients with lumbar degeneration were selected from May 2016 to May 2017 in the General Hospital of Western Theater Command.The lumbar BMD of all patients were measured by dual energy X-ray absorptiometry.The levels in fasting venous blood of procollagen type-1 N-terminal propeptide(PINP),Osteocalcin(OC),bone-specific alkaline phosphatase(BALP),C-terminal crosslinking telopeptides of type I collagen(β-CTX),25-hydroxy vitamin D(25-(OH)VitD)and tartrate resistant alkaline phosphatase(TRACP)were analyzed with Roche chemiluminescence.The past fragility fractures were analyzed by inquiring medical history and X-ray examination.The correlation between BTMs with BMD and fragility fracture risk were evaluated by multiple logistic regression and linear regression analysis.Results The incidence of fragility fractures in 158 patients with lumbar degeneration was 20.3%.The BMD was significantly lower in patients with fragility fracture than in patients with no fragility fracture(P<0.05).The levels of PINP,BALP,OC andβ-CTX were significantly higher in patients with fragility fracture than in those with no fragility fracture(P<0.05).PINP,BALP,OC,β-CTX and TRACP were negatively correlated with lumbar BMD(β=–0.431,–0.234,–0.167,–0.314 and–0.198,respectively;P=0.021,0.009,0.034,0.033 and 0.049,respectively),andβ-CTX and PINP were positively correlated with the fragility fracture risk(P<0.05).Conclusion PINP,BALP,OC,β-CTX and TRACP were negatively correlated with BMD,andβ-CTX and PINP were positively correlated with fragility fracture risk in patients with lumbar degeneration,implying that early monitoring BTMs and early anti-osteoporosis treatment may reduce the risk of long-term screw loosening and fragility fracture in patients with lumbar degeneration after surgery.
作者
徐伟
盛珺
刘达
郑伟
陈莹
任亚明
蔡云
夏宁
Xu Wei;Sheng Jun;Liu Da;Zheng Wei;Chen Ying;Ren Ya-Ming;Cai Yun;Xia Ning(Department of Orthopedics,the General Hospital of Western Theater Command,Chengdu 610083,China;School of Medicine,Southwest Jiaotong University,Chengdu 610031,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2020年第2期187-191,共5页
Medical Journal of Chinese People's Liberation Army
基金
四川省科技计划项目(2017SZ0116)
四川省干部保健科研课题(川干研2017-1301)
四川省卫生和计划生育委员会科研课题(16PJ020)
国家自然科学基金青年基金(81802206).
关键词
骨质疏松症
骨转换标志物
骨密度
脆性骨折
osteoporosis
bone turnover markers
bone mineral density
fragility fracture
