CAJ | 학술논문

目的：观察原发性骨质疏松症患者重组人甲状旁腺素[rhPTH（1-34）]治疗前后血清性激素结合球蛋白（SHBG）水平的变化，并分析其与rhPTH（1-34）治疗骨质疏松症效果的相关性。方法收集老年原发性骨质疏松症患者20例及健康体检者30例，原发性骨质疏松症患者进行rhPTH（1-34）治疗。分别于治疗前及治疗1年后检测血清SHBG水平、生化指标、性激素水平及腰椎（L2~4）骨密度（BMD），并对各项检测指标进行相关性分析。结果经rhPTH（1-34）治疗后，腰椎（L2~4）BMD值、T值较治疗前明显增加（P＜0.05或0.01），血磷、碱性磷酸酶（ALP）及雌二醇（E2）水平明显增高（P＜0.05或0.01）；血钙、促卵泡生成素（FSH）、睾酮（TT）、促黄体生成素（LH）、甘油三酯（TG）和胆固醇（TC）等指标治疗前后均无显著变化（均P＞0.05）。原发性骨质疏松症患者SHBG水平与正常对照组比较明显增高（P＜0.05），经rhPTH（1-34）治疗1年后SHBG水平明显降低（P＜0.05）。SHBG与BMD值、T值、E2水平变化呈明显负相关（r=-0.78、-0.67、-0.53，均P＜0.01）。结论原发性骨质疏松症患者经rhPTH（1-34）治疗后，血清SHBG水平显著下降，推测SHBG参与原发性骨质疏松症的形成过程，并在rhPTH（1-34）治疗中发挥重要作用。
목적：관찰원발성골질소송증환자중조인갑상방선소[rhPTH（1-34）]치료전후혈청성격소결합구단백（SHBG）수평적변화，병분석기여rhPTH（1-34）치료골질소송증효과적상관성。방법수집노년원발성골질소송증환자20례급건강체검자30례，원발성골질소송증환자진행rhPTH（1-34）치료。분별우치료전급치료1년후검측혈청SHBG수평、생화지표、성격소수평급요추（L2~4）골밀도（BMD），병대각항검측지표진행상관성분석。결과경rhPTH（1-34）치료후，요추（L2~4）BMD치、T치교치료전명현증가（P＜0.05혹0.01），혈린、감성린산매（ALP）급자이순（E2）수평명현증고（P＜0.05혹0.01）；혈개、촉란포생성소（FSH）、고동（TT）、촉황체생성소（LH）、감유삼지（TG）화담고순（TC）등지표치료전후균무현저변화（균P＞0.05）。원발성골질소송증환자SHBG수평여정상대조조비교명현증고（P＜0.05），경rhPTH（1-34）치료1년후SHBG수평명현강저（P＜0.05）。SHBG여BMD치、T치、E2수평변화정명현부상관（r=-0.78、-0.67、-0.53，균P＜0.01）。결론원발성골질소송증환자경rhPTH（1-34）치료후，혈청SHBG수평현저하강，추측SHBG삼여원발성골질소송증적형성과정，병재rhPTH（1-34）치료중발휘중요작용。
Objective To investigate the changes of serum sex hormone binding globulin(SHBG) levels in primary osteo-porotic patients after treatment with recombinant human parathyroid hormone rhPTH (1- 34). Methods Twenty elderly patients with osteoporosis were recruited and treated with rhPTH (1- 34). The serum SHBG level, biochemical index, sex hormone levels, and lumbar bone mineral density (L2~L4) were detected before and 1 year after treatment. And the correlations of these indexes were analyzed. Results After rhPTH (1- 34) treatment the BMD of lumbar spine (L2~L4) and the T value increased (P<0.05 or 0.01);the serum phosphorus and ALP levels were also significantly increased(P<0.05 or 0.01), SHBG and E2 levels were reduced (P<0.05);while there were no significant differences in FSH, calcium, TT, LH, triglyceride and cholesterol levels before and after treatment (P>0.05). SHBG levels of patients with primary osteoporosis were significantly increased compared with normal con-trols(P<0.05) and were significantly decreased one year after treatment(P<0.05). The serum level of SHBG was negatively cor-related with BMD, T values and E2 (r=- 0.78, r=- 0.67 and r=- 0.53, P<0.01). Conclusion After effective treatment with rhPTH (1- 34), the level of SHBG of primary osteoporosis patients is decreased significantly, which indicates that SHBG may be involved in the pathogenesis of primary osteoporosis and also associated with the efficacy of rhPTH (1- 34) treatment.