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目的分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者骨代谢标志物随着COPD病情发展的变化趋势。方法采用酶联免疫吸附法分别测定COPD急性加重期患者100例、稳定期患者100例及同龄健康体检者100例的血清C-反应蛋白(C-reactive protein,CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor–alpha,TNF-α)、Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of type Ⅰ collagen,β-CTX)、碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素(osteocalcin,OC)和Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprocollagen,PINP)水平的差异并分析病情发展对其的影响。结果与健康对照组相比,COPD急性加重期和稳定期患者血清CRP、IL-6、TNF-α、β-CTX、ALP、OC和PINP水平均明显升高,且急性加重期高于稳定期,3组间差异均有统计学意义(P<0.01);COPD急性加重期和稳定期患者PINP/β-CTX比值均低于健康对照组(P<0.01),急性加重期低于稳定期组(P<0.05)。结论 COPD患者尤其是急性加重期的患者,骨吸收功能异常活跃,骨量丢失明显增加,从而存在较高的继发骨质疏松的风险。
Objective To analyze the change trend of bone metabolic markers with the development of COPD in patients with chronic obstructive pulmonary disease (COPD). Methods Serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay in 100 patients with COPD exacerbation, 100 stable patients and 100 healthy controls. -6, IL-6), tumor necrosis factor-alpha (TNF-α), β-C-terminal telopeptide of type Ⅰ collagen Alkaline phosphatase (ALP), osteocalcin (OC) and type-Ⅰ propeptide of type Ⅰprocollagen (PINP) were detected by enzyme linked immunosorbent assay (ELISA). Results Compared with healthy control group, serum levels of CRP, IL-6, TNF-α, β-CTX, ALP, OC and PINP in patients with acute exacerbation and stable exacerbations of COPD were significantly higher than those in healthy controls (P <0.01). The ratio of PINP / β-CTX in patients with acute exacerbation and stable phase of COPD was lower than that of healthy controls (P <0.01), and the rate of acute exacerbation was lower than that of stable ones (P <0.05). Conclusions Patients with COPD, especially those with acute exacerbation, have abnormal bone resorption function and increased bone loss, which leads to the high risk of secondary osteoporosis.