绝经后骨质疏松性腰椎骨折骨代谢指标的变化.docVIP

绝经后骨质疏松性腰椎骨折骨代谢指标的变化 作者:李保林,谭建伟,利云峰 作者单位：广州市越秀区正骨医院，广东 广州 510045 【摘要】 目的 了解雌二醇和白细胞介素6等骨代谢指标在骨质疏松症发病中的作用。方法 选择女性腰椎骨折患者120 例，绝经后有骨质疏松者60 例(OP组)，绝经后无骨质疏松者30 例(NOP组)，另外选择绝经前妇女30 例为对照组。对120名妇女雌二醇、骨密度、白细胞介素6、血清总碱性磷酸酶、骨钙素、尿羟脯氨酸肌酐比值、尿钙肌酐比值等指标进行了测定。结果 绝经后妇女骨形成指标骨钙素及碱性磷酸酶明显高于对照组妇女，其中碱性磷酸酶在OP组和NOP组间有差异，而骨钙素在OP组和NOP组间无差异；绝经后妇女骨吸收指标尿羟脯氨酸肌酐比值及尿钙肌酐比值明显高于对照组妇女，OP组又明显高于NOP组；绝经后妇女的血清雌二醇的含量明显低于对照组(绝经前妇女)，OP组又明显低于NOP组；绝经后妇女血清白细胞介素6的含量明显高于对照组妇女，而OP组又明显高于NOP组。结论 雌二醇、白细胞介素6等骨代谢指标与骨质疏松关系密切。这充分说明雌激素水平的下降，IL6分泌增多，导致骨吸收加速。 【关键词】 骨质疏松症；腰椎骨折；骨代谢 　　Study on Parameter of the Bone Metabolism Changes in Lumbar Vertebrae Fracture Patient of Postmenopausal Osteoporosis 　　LI Baolin， TAN Jianwei， LI Yunfeng， et al 　　(OrthopedicTraumatological Hospital of Yuexiu District， Guangzhou 510045， China) 　　Abstract： Objective To explore the role of parameter of the bone metabolism in onset of osteoporosis. Methods We chose 120 women with lumbar vertebrae fracture(90 cases postmenopausal and 30 premenopausal). These women were divided into the three groups： osteoporosis group(OP，60 cases) and nonosteoporosis group(NOP，30 cases). 30 normal premenopausal women were chose as the control group. The BMD，the serum levels of E2， Alkaline phosphatase(ALP)， Osteocalcin(bone Γcarboxyglutamic acidcontaining protein， BGP) and the Urinary hydroxyproline(UHyp)/creatinine(Cr，Urinary Ca(UCa)/Cr were measured. Results The level of BGP，ALP， IL6 in postmenopausal women was significantly higher than that in the the control group(P＜0.01)， the level of the UHyp/Cr and UCa/Cr was significantly higher than in the the control group too(P＜0.01)， whereas the BMD and the level of E2 in postmenopausal women was significantly lower than that in the control group. (P＜0.01). There was significantly difference in BMD， E2， IL6， ALP， UHyp/Cr and UCa/Cr between OP and NOP group. Conclusion There is some relationship between the decreased expression of E2 and the increased expressio