中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2012年
2期
136-139
,共4页
张程%蒋铁桥%杨刚毅%刘东方%郭常辉%张利莉%李伶%李钶
張程%蔣鐵橋%楊剛毅%劉東方%郭常輝%張利莉%李伶%李鈳
장정%장철교%양강의%류동방%곽상휘%장리리%리령%리아
重组人甲状旁腺素(1-34)%依降钙素%骨质疏松症%富含半胱氨酸酸性蛋白
重組人甲狀徬腺素(1-34)%依降鈣素%骨質疏鬆癥%富含半胱氨痠痠性蛋白
중조인갑상방선소(1-34)%의강개소%골질소송증%부함반광안산산성단백
Recombinant human parathyroid hormone (1-34)%Elcatonin%Osteoporosis%Secreted protein acidic and rich in cysteine
目的 观察重组人甲状旁腺素(1-34)[ rhPTH(1-34)]和依降钙素对绝经后女性骨质疏松患者骨密度和骨代谢及血清富含半胱氨酸的酸性蛋白( SPARC)水平的影响.方法 124例绝经后女性骨质疏松症患者随机分为PTH组(n=89),给予rhPTH (1-34)200 U皮下注射每日一次和CT组(n=35),给予依降钙素20U肌肉注射每周一次,共12个月.于治疗前、治疗后6个月、12个月测定各组一般生化指标,腰椎L2-4、左股骨颈、大转子及Ward三角的骨密度、血清钙、磷水平.采用酶联免疫法(ELISA)测定血清骨碱性磷酸酶(BSAP)、富含半胱氨酸的酸性蛋白(SPARC)等骨代谢相关指标水平情况.结果 rhPTH治疗12个月后腰椎L2-4骨密度较基线增加了7.9%(P<0.05);血清钙和BSAP水平12个月时较治疗前分别增加了8.3%和93.4%(均P<0.05);血清SPARC水平12个月时较基线增加了12.6%(P<0.05);与治疗前相比,依降钙素治疗12个月时腰椎L2-4骨密度增加了3.2%(P<0.05);血清钙、BSAP和SPARC水平均无显著改变.结论 rhPTH (1-34)能显著促进骨合成代谢,其疗效优于依降钙素;血清SPARC水平的增加可能在rhPTH促进成骨过程中起重要作用.
目的 觀察重組人甲狀徬腺素(1-34)[ rhPTH(1-34)]和依降鈣素對絕經後女性骨質疏鬆患者骨密度和骨代謝及血清富含半胱氨痠的痠性蛋白( SPARC)水平的影響.方法 124例絕經後女性骨質疏鬆癥患者隨機分為PTH組(n=89),給予rhPTH (1-34)200 U皮下註射每日一次和CT組(n=35),給予依降鈣素20U肌肉註射每週一次,共12箇月.于治療前、治療後6箇月、12箇月測定各組一般生化指標,腰椎L2-4、左股骨頸、大轉子及Ward三角的骨密度、血清鈣、燐水平.採用酶聯免疫法(ELISA)測定血清骨堿性燐痠酶(BSAP)、富含半胱氨痠的痠性蛋白(SPARC)等骨代謝相關指標水平情況.結果 rhPTH治療12箇月後腰椎L2-4骨密度較基線增加瞭7.9%(P<0.05);血清鈣和BSAP水平12箇月時較治療前分彆增加瞭8.3%和93.4%(均P<0.05);血清SPARC水平12箇月時較基線增加瞭12.6%(P<0.05);與治療前相比,依降鈣素治療12箇月時腰椎L2-4骨密度增加瞭3.2%(P<0.05);血清鈣、BSAP和SPARC水平均無顯著改變.結論 rhPTH (1-34)能顯著促進骨閤成代謝,其療效優于依降鈣素;血清SPARC水平的增加可能在rhPTH促進成骨過程中起重要作用.
목적 관찰중조인갑상방선소(1-34)[ rhPTH(1-34)]화의강개소대절경후녀성골질소송환자골밀도화골대사급혈청부함반광안산적산성단백( SPARC)수평적영향.방법 124례절경후녀성골질소송증환자수궤분위PTH조(n=89),급여rhPTH (1-34)200 U피하주사매일일차화CT조(n=35),급여의강개소20U기육주사매주일차,공12개월.우치료전、치료후6개월、12개월측정각조일반생화지표,요추L2-4、좌고골경、대전자급Ward삼각적골밀도、혈청개、린수평.채용매련면역법(ELISA)측정혈청골감성린산매(BSAP)、부함반광안산적산성단백(SPARC)등골대사상관지표수평정황.결과 rhPTH치료12개월후요추L2-4골밀도교기선증가료7.9%(P<0.05);혈청개화BSAP수평12개월시교치료전분별증가료8.3%화93.4%(균P<0.05);혈청SPARC수평12개월시교기선증가료12.6%(P<0.05);여치료전상비,의강개소치료12개월시요추L2-4골밀도증가료3.2%(P<0.05);혈청개、BSAP화SPARC수평균무현저개변.결론 rhPTH (1-34)능현저촉진골합성대사,기료효우우의강개소;혈청SPARC수평적증가가능재rhPTH촉진성골과정중기중요작용.
Objective To investigate the effect of rhPTH (1-34) and elcatonin on bone metabolism and serum secreted protein acidic and rich in cysteine ( SPARC ) in postmenopausal women with osteoporosis.Methods One hundred and twenty-four postmenopausal women with osteoporosis were randomly divided into 2 groups:One group was treated with recombinant human parathyroid hormone ( 1-34 ) [ rhPTH ( 1-34 ) ] 200 U/d by subcutaneous injection (PTH group,n =89 )and another group was treated with elcatonin 20 U/week by intramuscular injection (CT group,n =35 ) for 12 months.All patients received a basic therapy with oral calcium ( Ca 600 mg+ Vit D3125 U,q..d.).The bone mineral density ( BMD ) of lumbar spine( L2-4 ),the left femoral neck,greater trochanter,and Ward's triangle,serum calcium and phosphate were measured by baseline,6 months' and 12 months.Levels of serum bone-specific alkaline phosphatase( BSAP),serum secreted protein acidic and rich in cysteine (SPARC)were determined by an ELISA assay.Results By 12 months,rhPTH ( 1-34 ) treatment significantly increased the lumbar spine L2-4 BMD 7.9% (P<0.05),serum calcium 8.3 % ( P< 0.05 ),serum BSAP 93.4% ( P< 0.05 ),serum SPARC by 12.6%[ ( 195.68±59.57 vs 173.81 ±81.33 ) pμg/L,P<0.05 ].Elcatonin therapy increased the lumbar spine L2-4 BMD by 3.2% (P<0.05) at the end of 12 months,but elcatonin did not influence serum calcium,BSAP and SPARC.The rhPTH( 1-34 ) increased lumbar spine L2-4 BMD more than elcatonin did at 12 months( P<0.05 ).Conclusion rhPTH (1-34) could promote the bone anabolism more effectively than elcatonin did.Serum SPARC may play an important role in promoting osteogenesis by rhPTH.