血清组织蛋白酶K在骨质疏松症诊断中的应用

doi:10.3969/j.issn.1673-8640.2016.08.003

摘要/Abstract

摘要：

目的探讨血清组织蛋白酶K（Cathe K）在骨质疏松症中的应用价值及意义。方法采用双能X线骨密度仪测定受检者腰椎及股骨颈的骨密度,根据骨密度值将187例受检者分为骨量减少组63例、骨质疏松症组124例。骨质疏松症组中有32例女性患者接受药物疗效监测。另选取体检者142名作为正常对照组。采用酶联免疫吸附试验（ELISA）检测所有受检者血清Cathe K、抗酒石酸酸性磷酸酶（TRAP）水平;同时采用电化学发光法检测骨钙素（N-MID）、β-胶原降解产物（β-crosslaps）、Ⅰ型前胶原氨基端前肽（PⅠNP）水平。各组按年龄再分为35~45岁组、46~55岁组、56~65岁组、66~70岁组、≥71岁组。结果骨质疏松症组35~45、46~55和56~65岁3个年龄段血清Cathe K水平均明显高于正常对照组同年龄段（P<0.01）,而66~70及≥71岁与正常对照组同年龄段比较差异均无统计学意义（P>0.05）。骨量减少组血清Cathe K水平除35~45岁与正常对照组同年龄段相比明显增高（P<0.01）外,其余各年龄段与正常对照组同年龄段比较差异均无统计学意义（P>0.05）。对各组46~65岁人群的骨转换标志物进行分析,骨质疏松症组血清Cathe K、PⅠNP、β-crosslaps、N-MID、TRAP水平与骨量减少组及正常对照组比较差异均有统计学意义（P<0.05）;而骨量减少组与正常对照组之间各项指标差异均无统计学意义（P>0.05）。骨质疏松症患者按治疗方案治疗3个月后,血清β-crosslaps、Cathe K明显低于治疗前（P<0.05）。结论血清Cathe K可用于骨质疏松症的诊断及疗效观察。

关键词: 组织蛋白酶K, 破骨细胞, 骨转换指标, 骨质疏松症

Abstract:

Objective To investigate the levels of serum cathepsin K（Cathe K） in osteoporosis diagnosis. Methods Bone mineral densities of lumbar spine and femoral neck were measured by dual energy X-ray. According to bone mineral densities,187 objects were classified into 63 cases of bone loss and 124 cases of osteoporosis. In osteoporosis group,32 cases' drug treatment efficacy was monitored. A total of 142 healthy subjects were enrolled as healthy control group. Enzyme-linked immunosorbent assay was used to determine serum Cathe K and tartrate-resistant acid phosphatase（TRAP）levels. The levels of osteocalcin（N-MID）,beta-collagen degradation product（β-crosslaps） and type Ⅰ procollagen N-terminal propeptide（PⅠNP）were determined by electrochemiluminescence immunoassay. According to ages,objects were classified into 35-45,46-55,56-65,66-70 and ≥71-year-old groups. Results For 35-45,46-55 and 56-65-year-old groups,the levels of serum Cathe K in osteoporosis group were higher than those in healthy control group（P<0.01）,but there was no statistical significance for 66-70 and ≥71-year-old groups between osteoporosis and healthy control groups （P>0.05）. For 35-45-year-old group,the level of serum Cathe K in bone loss group was higher than that in healthy control group（P<0.01）,and there was no statistical significance for the other age groups（P>0.05）. In the analysis of bone turnover markers for 45-65-year-old groups,the levels of serum Cathe K,PⅠNP,β-crosslaps,N-MID and TRAP in osteoporosis group were higher than those in bone loss and healthy control groups（P<0.05）. There was no statistical significance between bone loss and healthy control groups（P>0.05）. Serum β-crosslaps and Cathe K decreased in osteoporosis group after treatment for 3 months（P<0.05）. Conclusions Serum Cathe K can be used in the diagnosis and treatment monitoring of osteoporosis.

Key words: Cathepsin K, Osteoclast, Bone turnover markers, Osteoporosis

中图分类号:

R446.1

王蓉, 沈安达, 朱福瑛, 周赢梁, 牟筱倩, 陈广洁. 血清组织蛋白酶K在骨质疏松症诊断中的应用[J]. 检验医学, 2016, 31(8): 647-651.

WANG Rong, SHEN Anda, ZHU Fuying, ZHOU Yingliang, MU Xiaoqian, CHEN Guangjie. Serum cathepsin K in osteoporosis diagnosis[J]. Laboratory Medicine, 2016, 31(8): 647-651.

图/表 3

参考文献 17

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组别	例数	年龄（岁）	Cathe K （ng/L）	PⅠNP （ng/mL）	B-crosslaps （ng/mL）	N-MID （ng/mL）	TRAP （pg/L）
骨量减少组	50	46~65	25.6±14.7^*	46.6±6.4^*	0.6±0.3^*	12.9±3.8^*	2 433.2±474.9^*
骨质疏松症组	100	46~65	33.0±17.9	79.7±5.9	0.9±0.3	17.7±5.4	2 727.5±1 297.2
正常对照组	60	46~65	24.6±8.2^*	46.3±4.6^*	0.6±0.1^*	11.8±2.9^*	2 403.2±408.1^*

组别	例数	年龄（岁）	Cathe K （ng/L）	PⅠNP （ng/mL）	B-crosslaps （ng/mL）	N-MID （ng/mL）	TRAP （pg/L）
骨量减少组	50	46~65	25.6±14.7^*	46.6±6.4^*	0.6±0.3^*	12.9±3.8^*	2 433.2±474.9^*
骨质疏松症组	100	46~65	33.0±17.9	79.7±5.9	0.9±0.3	17.7±5.4	2 727.5±1 297.2
正常对照组	60	46~65	24.6±8.2^*	46.3±4.6^*	0.6±0.1^*	11.8±2.9^*	2 403.2±408.1^*

项目	例数	Cathe K	β-crosslaps
治疗前	32	27.00±27.60	0.59±0.29
治疗后
3个月	32	16.20±5.60^*	0.33±0.16^*
6个月	32	13.10±2.80^*	0.11±0.09^*

项目	例数	Cathe K	β-crosslaps
治疗前	32	27.00±27.60	0.59±0.29
治疗后
3个月	32	16.20±5.60^*	0.33±0.16^*
6个月	32	13.10±2.80^*	0.11±0.09^*