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目的探讨血友病患者体内骨代谢相关生化指标及细胞因子的特点。方法收集2015年3—9月于华北理工大学附属医院血液科就诊的22例血友病患者,同时收集同性别,同年龄组的30例来院体检的健康男性作为对照组,所有研究对象均接受了血清人Ⅰ型胶原交联N末端肽(NTXⅠ),人骨保护素(OPG),人骨碱性磷酸酶(BALP),人碱性成纤维细胞生长因子(bFGF),人类胰岛素样生长因子(IGF),人转化生长因子β1(TGF-β1)水平检测,血友病患者接受了骨密度检测。依据世界卫生组织(WHO)定义,用测量Z值水平评估骨密度(BMD)的临床意义。结果健康对照组30例,血友病组22例,健康对照组血清人骨碱性磷酸酶(BALP),人Ⅰ型胶原交联N末端肽(NTXⅠ)、人碱性成纤维细胞生长因子(bFGF),均高于血友病患者组(P<0.05)。22例血友病患者均接受骨密度检测,其中Z值>-2组11例,Z值≤-2组11例;Z值≤-2组反应骨形成的血清人骨源性碱性磷酸酶(BALP)水平低于健康对照组(P<0.05)。结论血友病患者骨代谢低于正常人群,成骨细胞活性减弱更为明显;血友病患者骨质流失的机制可能与成骨细胞活性降低有关;血友病疾病本身可能导致b-FGF降低,从而影响骨代谢。
Objective To investigate the biochemical markers of bone metabolism in patients with hemophilia and the characteristics of cytokines. Methods Totally 22 hemophiliacs were enrolled in Department of Hematology, Affiliated Hospital of North China Polytechnic University, from March to September, 2015. Meanwhile, 30 healthy men of the same sex and same age group were collected as control group. All the subjects received Serum human type Ⅰ collagen crosslinked N-terminal peptide (NTXⅠ), human osteoprotegerin (OPG), human bone alkaline phosphatase (BALP), human basic fibroblast growth factor (bFGF), human insulin-like growth factor ), Human transforming growth factor β1 (TGF-β1) levels, and hemophilia patients undergoing bone mineral density testing. According to the definition of the World Health Organization (WHO), the clinical significance of measuring bone mineral density (BMD) by measuring the level of Z value. Results In the control group, there were 30 healthy controls, 22 hemophilia patients, and serum levels of human bone alkaline phosphatase (BALP), human collagen type Ⅰ collagen N-terminal peptide (NTXⅠ), human basic fibroblast growth factor ) Were higher than hemophilia patients (P <0.05). Twenty-two patients with hemophilia received bone mineral density test, including 11 in Z group> -2 group and 11 in Z group ≤ -2 group. Serum human bone-derived alkaline phosphatase BALP) was lower than the healthy control group (P <0.05). Conclusion The bone metabolism in patients with hemophilia is lower than that in normal people, and the activity of osteoblasts is weakened more obviously. The mechanism of bone loss in patients with hemophilia may be related to the decrease of osteoblast activity. The hemophilia disease itself may lead to the decrease of b-FGF , Thus affecting bone metabolism.