摘要
目的探讨慢性痛风性关节炎患者骨代谢的水平及临床意义。方法采用电化学发光免疫分析法检测30例急性痛风性关节炎患者(AG组)、30例高尿酸血症患者(HU组)、60例慢性痛风性关节炎患者(CG组)和30例健康体检者(HC组)的血清骨钙素(OC)、Ⅰ型原胶原N端前肽(PINP)和Ⅰ型胶原C端交联肽(CTX)的水平。分析CG组患者骨代谢指标OC、PINP和CTX分别与年龄、BMI、急性关节炎病程、高尿酸病程、血清尿酸、FBG、血脂、CRP、ESR、IL-6、痛风石以及关节超声改变等因素的相关性。结果骨代谢指标OC、PINP以及CTX水平在AG组、HU组和CG组呈逐渐升高的趋势;其中,CG组血清CTX水平高于HC组和AG组[(453.75±134.69) ng/L vs.(319.74±83.94) ng/L和(306.76±84.95) ng/L](P<0.05)。相关性分析结果显示,CG组患者OC与痛风石、ESR、IL-6、关节内尿酸盐呈正相关(P<0.05),与FBG、三酰甘油呈负相关(P<0.05);PINP与痛风石、ESR、IL-6、关节内尿酸盐呈正相关(P<0.05);CTX与痛风石、关节内尿酸盐呈正相关(P<0.05),与滑膜血流信号呈负相关(P<0.05)。多元线性回归分析显示,关节内尿酸盐是CG组患者骨代谢失衡的危险因素(P<0.05)。结论慢性痛风性关节炎患者存在骨代谢失衡,其骨代谢水平与痛风石、FBG、三酰甘油、IL-6、ESR、关节内尿酸盐等多因素相关。关节内尿酸盐可能是骨破坏的重要因素。
Objective To investigate the level and clinical significance of bone metabolism in the patients with chronic gouty arthritis.Methods Serum levels of osteocalcin(OC),N-terminal propeptide of typeⅠprocollagen(PINP)and C-terminal cross-linking telopeptide of typeⅠcollagen(CTX)were detected by electrochemiluminescence immunoassay in 30 patients with acute gouty arthritis(group AG),30 patients with hyperuricemia(group HU),60 patients with chronic gouty arthritis(group CG)and 30 healthy people(group HC).The correlations of OC,PINP and CTX with age,body mass index,acute arthritis course,hyperuricemia course,serum uric acid,fasting blood glucose(FBG),blood lipids,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),gouty tophus and joints ultrasound were analyzed.Results Serum levels of OC,PINP and CTX were gradually increased in an order of group CG>group HU>group AG.Serum level of CTX in group CG was higher than that in groups of HC and AG[(453.75±134.69)ng/L vs.(319.74±83.94)ng/L and(306.76±84.95)ng/L](P<0.05).The results of correlation analysis showed that OC was positively correlated with gouty tophus,ESR,IL-6,joint urate and negatively correlated with FBG and triacylglycerol,PINP was positively correlated with gouty tophus,ESR,IL-6 and joint urate,CTX was positively correlated with gouty tophus and joint urate and negatively correlated with synovial blood flow in group CG(P<0.05).The results of multiple linear regression correlation analysis showed that intraarticular urate was an independent risk factor for the imbalance of bone metabolism in group CG(P<0.05).Conclusion Bone metabolic imbalance exists in the patients with chronic gouty arthritis.The bone metabolism level is related to the gouty tophus,FBG,triacylglycerol,IL-6,ESR and joint urate.Joint urate may be a high risk factor for bone destruction.
作者
芮金兵
王燕茹
史伟
尚梦圆
邓家良
裘影影
汤郁
RUI Jinbing;WANG Yanru;SHI Wei(Department of Rheumatology,Affiliated Hospital,Jiangsu University,Zhenjiang 212001,CHINA)
出处
《江苏医药》
CAS
2021年第6期562-565,571,共5页
Jiangsu Medical Journal
基金
国家自然科学基金(81571582)
2017年高层次卫生人才“六个一工程”项目(LGY2017101)
江苏省“333”工程项目
江苏大学5123计划项目。
关键词
痛风性关节炎
骨代谢
Gouty arthritis
Bone metabolism
