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目的 测定绝经前女性系统性红斑狼疮患者骨密度 (BMD)与骨代谢的生化参数并探讨二者的相关性。方法 用双能量x线吸收测量仪测定 3 0例SLE患者腰椎和股骨BMD ;常规测定分别测定 3 0例SLE患者和 3 9名正常健康者校正后的血清钙、磷、碱性磷酸酶、肌酐和白蛋白 ,用ELISA法测定卵泡促激素、黄体生成素、甲状旁腺素、骨钙素、脱氧吡诺林的分泌 ,用RIA法测定雌二醇、孕酮、睾丸酮、2 5 -OH维生素D、I型原胶原C端前肽、碱性磷酸酶骨特异性同工酶、交联的I型胶原端肽。结果 根据世界卫生组织的标准 ,在腰椎位点 3 9%患者BMD正常 ,46%患者骨质减少 ,15 %患者骨质疏松 ;在股骨颈位点 ,3 8 5 %患者BMD正常 ,3 8 5 %患者骨质减少 ,2 3 %患者骨质疏松。狼疮患者骨钙素、血清磷显著性降低 ( P =0 0 3、P =0 0 0 2 ) ,而患者校正后的血清钙则显著性升高 (P =0 0 0 0 1) ;除了患者睾丸酮的血清水平降低和卵泡促激素血清水平升高外 (P =0 0 0 1、P =0 42 ) ,其它性激素水平没有显著性差异。结论 绝经前女性SLE患者腰椎和股骨颈的骨质疏松和骨质减少发生率高 ,至少部分因骨形成的减少所致。
Objective To determine the biochemical parameters of bone mineral density (BMD) and bone metabolism in premenopausal women with systemic lupus erythematosus (SLE) and to explore their correlation. Methods BMD of lumbar spine and femur in 30 SLE patients were measured by dual-energy x-ray absorptiometry. The corrected serum calcium, phosphorus, alkaline phosphatase and creatinine were measured in 30 SLE patients and 39 normal controls And albumin. The secretions of follicle-stimulating hormone, luteinizing hormone, parathyroid hormone, osteocalcin and deoxypyronin were measured by ELISA. The contents of estradiol, progesterone, testosterone, 25-OH vitamins D, type C procollagen C-terminal propeptide, alkaline phosphatase-specific isozyme, cross-linked type I collagen peptide. Results According to WHO criteria, BMD was normal in 39% of lumbar vertebrae, osteopenia in 46% and osteoporosis in 15% of patients. In femoral neck, 385% of patients had normal BMD and 385% Patients with osteopenia, 23% of patients with osteoporosis. In patients with lupus, osteocalcin and serum phosphorus decreased significantly (P = 0 0 3, P = 0 0 0 2), but corrected serum calcium increased significantly (P 0 0 0 0 1). In addition to patients Testosterone serum levels and follicle-stimulating hormone serum levels increased (P = 0 0 0 1, P = 0 42), other sex hormone levels did not differ significantly. Conclusions The incidence of osteoporosis and osteopenia in the lumbar and femoral neck in premenopausal women with SLE is high, at least in part because of reduced bone formation.