论文部分内容阅读
目的:探讨Ⅰ型神经纤维瘤病(neurofibromatosis type 1,NF1)伴脊柱侧凸患者骨密度(BMD)与血清骨钙素(BGP)及骨代谢生化指标的相关性。方法:选取2012年2月~2013年3月我院脊柱外科收治的17例NF1伴脊柱侧凸(NF1-S)患者为观察对象(病例组),年龄8~18岁,Cobb角40°~143°;17例正常儿童及青少年作为对照组,年龄7~19岁。两组均采用双能X线骨密度吸收仪测量非优势侧的股骨近端和腰椎(L2~L4)的BMD,同时采用免疫分析仪检测BGP水平,血生化分析仪检测碱性磷酸酶(ALP)、血钙(血Ca)、血磷(血P)、尿钙/肌酐比值(尿Ca/Cr)和尿磷/肌酐比值(尿P/Cr)。应用SPSS 16.0软件进行统计分析,采用独立样本t检验分析两组BMD及各项骨代谢生化指标之间的差异;Pearson相关分析病例组患者腰椎BMD与对应各项骨代谢生化指标的相关关系。结果:两组受试者年龄、性别构成比无统计学差异(P>0.05)。病例组所测各部位BMD均明显低于正常对照组,差异有显著性(P<0.05);BGP(135.6ng/ml)、血Ca(2.59mmol/L)、血P(1.75mmol/L)、尿Ca/Cr(0.10mg/mg)均高于正常对照组(79ng/ml、2.45mmol/l、1.47mmol/l、0.06mg/mg),差异均具有显著性(P<0.05),而ALP(141.6u/L vs 141.8u/l,t=3.611,P=0.991)和尿P/Cr(0.47mg/mg vs 0.46mg/mg,t=0.054,P=0.957)则无显著性差异(P>0.05)。NF1-S患者腰椎BMD与BGP(r=-0.916,P=0.000)、尿Ca/Cr(r=-0.968,P=0.000)存在显著性负相关。结论:NF1-S患者BMD明显低于正常人;BGP、血Ca、血P和尿Ca/Cr均高于正常人,测定BGP、尿Ca/Cr水平是监测NF1-S患者BMD变化较为敏感的方法之一。
Objective: To investigate the relationship between bone mineral density (BMD) and serum osteocalcin (BGP) and biochemical markers of bone metabolism in patients with type 1 neurofibromatosis type 1 (NF1) and scoliosis. Methods: Seventeen patients with NF1-scoliosis (NF1-S) admitted to our hospital from February 2012 to March 2013 were enrolled in this study. The patients were aged 8 to 18 years old and Cobb angle was 40 ° ~ 143 °; 17 normal children and adolescents as a control group, aged 7 to 19 years. BMD of proximal femur and lumbar vertebrae (L2 ~ L4) were measured by dual-energy X-ray absorptiometry in both groups. BGP was detected by immunoassay analyzer, and alkaline phosphatase (ALP) ), Blood calcium (blood Ca), phosphorus (blood P), urinary calcium / creatinine ratio (urinary Ca / Cr) and urinary phosphorus / creatinine ratio (urinary P / Cr). SPSS 16.0 software was used for statistical analysis. Independent sample t-test was used to analyze the difference of BMD and biochemical markers of bone metabolism. Pearson correlation analysis was used to analyze the correlation between lumbar spine BMD and corresponding biochemical markers of bone metabolism. Results: There was no significant difference in age and sex between the two groups (P> 0.05). The BMD in each group was significantly lower than that in the normal control group (P <0.05). BGP (135.6ng / ml), blood Ca (2.59mmol / L) and blood P (1.75mmol / L) , Urine Ca / Cr (0.10mg / mg) were higher than the normal control group (79ng / ml, 2.45mmol / l, 1.47mmol / l, 0.06mg / There was no significant difference between ALP (141.6u / L vs 141.8u / l, t = 3.611, P = 0.991) and urinary P / Cr (0.47mg / mg vs 0.46mg / P> 0.05). BMD of lumbar spine in NF1-S patients was significantly negatively correlated with BGP (r = -0.916, P = 0.000) and urinary Ca / Cr (r = -0.968, P = 0.000). CONCLUSIONS: The BMD in patients with NF1-S is significantly lower than that in normal subjects. The levels of BGP, blood Ca, blood P and urinary Ca / Cr are higher than those in normal subjects. The determination of BGP and urinary Ca / Cr levels is more sensitive in monitoring the changes of BMD in patients with NF1-S One of the ways.