绝经后骨质疏松性腰椎骨折骨代谢指标的变化.doc

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1、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，庾伟中，杨冰【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

2、，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　　StudyonParameteroftheBoneMetab

3、olismChangesinLumbarVertebraeFracturePatientofPostmenopausalOsteoporosis　　Abstract：ObjectiveToexploretheroleofparameterofthebonemetabolisminonsetofosteoporosis.MethodsWechose120womenwithlumbarvertebraefracture(90casespostmenopausaland30premenopausal).Thesewomenw

4、eredividedintothethreegroups：osteoporosisgroup(OP，60cases)andnonosteoporosisgroup(NOP，30cases).30normalpremenopausalwomenwerechoseasthecontrolgroup.TheBMD，theserumlevelsofE2，Alkalinephosphatase(ALP)，Osteocalcin(boneγcarboxyglutamicacidcontainingprotein，BGP)and

5、theUrinaryhydroxyproline(UHyp)/creatinine(Cr，UrinaryCa(UCa)/Crweremeasured.ResultsThelevelofBGP，ALP，IL6inpostmenopausalwomenwassignificantlyhigherthanthatinthethecontrolgroup(P＜0.01)，theleveloftheUHyp/CrandUCa/Crwassignificantlyhigherthaninthethecontrolgrou

6、ptoo(P＜0.01)，whereastheBMDandthelevelofE2inpostmenopausalwomenwassignificantlylowerthanthatinthecontrolgroup.(P＜0.01).TherewassignificantlydifferenceinBMD，E2，IL6，ALP，UHyp/CrandUCa/CrbetweenOPandNOPgroup.ConclusionThereissomerelationshipbetweenthedecreasedexpr

7、essionofE2andtheincreasedexpressionofIL6，thedecreasedexpressionofE2mayactivate5thecellsproducingIL6，whichleadstotheincreasedexpressionofIL6；theincreasedexpressionofIL6enhancestheboneresorption，whichleadstotheincreaseofUHyp/Cr，UCa/CranddecreaseofBMD，andthisi

8、soneofpossibleimportantreasonsforosteoporosis.　　Keywords：osteoporosis；lumbarvertebraefracture；bonemetabolism　　骨质疏松是以骨量减少、骨组织显微结构退化(松质骨骨小梁变细、断裂、数量减少，皮质骨多孔、变薄)为特征，以致骨的脆