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目的通过测定强直性脊柱炎(AS)男性患者血清骨特异性碱性磷酸酶(BALP)、血清骨钙素(sOC)、尿Ⅰ型胶原C末端肽(CTX-Ⅰ)水平,以探讨与疾病活动性、骨密度(BMD)的关系。方法用ELISA方法测定35名AS患者血清BALP、sOC、尿CTX-Ⅰ;用双能X线吸收法(DEXA)测定腰椎正位(AP)L1-L4总体和股骨颈的BMD,根据Bath强直性脊柱炎疾病活动指数(BASDAI)对患者病情进行评分,并与70名健康者对照。结果AS患者尿CTX-Ⅰ水平显著高于对照组(P<0.05);直线相关显示,尿CTX-Ⅰ水平与股骨颈BMD呈负相关(r=-0.414,P<0.05),与BASDAI、C反应蛋白(CRP)呈正相关(r=0.445,P<0.05;r=0.491,P<0.01)。AS患者血清BALP、sOC水平与对照组无统计学意义,且与BMD、BASDAI无明显相关性。结论CTX-Ⅰ水平升高提示患者骨吸收增强、骨密度降低、疾病呈活动性。
Objective To determine the levels of serum bone specific alkaline phosphatase (BALP), serum osteocalcin (sOC) and urinary type Ⅰ collagen C-terminal peptide (CTX-Ⅰ) in male patients with ankylosing spondylitis (AS) Activity, bone mineral density (BMD) relationship. Methods Serum BALP, sOC and urine CTX-Ⅰ were measured by ELISA in 35 AS patients. BMD of L1-L4 total and femoral neck were measured by dual-energy X-ray absorptiometry (DEXA) The patient’s condition was scored by the Spondylitis Disease Activity Index (BASDAI) and compared with 70 healthy controls. Results The urinary CTX-Ⅰ level in patients with AS was significantly higher than that in the control group (P <0.05). The linear correlation between urine CTX-Ⅰ and BMD of femoral neck was negative (r = -0.414, P <0.05) Reactive protein (CRP) was positively correlated (r = 0.445, P <0.05; r = 0.491, P <0.01). The serum levels of BALP and sOC in patients with AS were not significantly different from those in control group, and had no significant correlation with BMD and BASDAI. Conclusion The high level of CTX-Ⅰ indicates that the bone resorption is enhanced, the bone mineral density is decreased and the disease is active.