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目的研究老年脑梗塞患者骨质疏松相关骨密度、骨生化与骨转换等指标变化。方法应用骨密度仪对受试者足踝部进行骨密度(BMD)测定。应用偶氮胂Ⅲ法检测血钙与钼酸盐法检测血磷,应用双抗体夹心法检测血清25羟基维生素D3(25(OH)D3)、甲状旁腺素(PTH)、骨钙素(BGP)、1型胶原羧基末端肽(β-CTX)、1型前胶原氨基端肽(P1NP)和骨源性碱性磷酸酶(BALP)。结果 85例老年脑梗塞患者骨质疏松自我筛查(OSTA)指数属高风险22例,女性老年脑梗塞患者OSTA指数与男性比较差异有统计学意义(P<0.05),OSTA指数风险分组与骨密度相关(P=0.01)。另外,男性与女性老年脑梗塞患者血清25(OH)D含量与骨形成指标(PTH、BGP、P1NP和BALP)均具有相关性(P<0.01),女性患者血Ca2+、血P3+、25(OH)D3、PTH、BGP和P1NP高于男性,差异有统计学意义(P<0.05~0.01)。结论老年脑梗塞患者普遍存在骨质疏松现象,且女性患者尤为严重,有必要进行骨质疏松综合干预治疗。
Objective To study the changes of osteoporosis-related bone mineral density, bone biochemistry and bone turnover in elderly patients with cerebral infarction. Methods Bone mineral density (BMD) measurements were performed on the ankle and foot of the subjects. Serum phosphorus was detected by arsenazo Ⅲ method in serum and molybdate. Serum 25-hydroxyvitamin D3 (25 (OH) D3), parathyroid hormone (PTH), osteocalcin (BGP) ), Type 1 collagen carboxyterminal peptide (β-CTX), type 1 procollagen aminoterminal peptide (P1NP) and osteogenic alkaline phosphatase (BALP). Results OSTA index was found in 22 elderly patients with cerebral infarction. The OSTA index in elderly female patients with cerebral infarction was significantly higher than that in male (P <0.05) Density-related (P = 0.01). In addition, serum 25 (OH) D levels were correlated with bone formation parameters (PTH, BGP, P1NP and BALP) in both male and female patients with cerebral infarction (P <0.01) ) D3, PTH, BGP and P1NP were significantly higher than those in males (P <0.05 ~ 0.01). Conclusion The prevalence of osteoporosis in elderly patients with cerebral infarction, and particularly severe in women, it is necessary for the comprehensive treatment of osteoporosis.