CAJ | 학술논문

目的：研究进行期寻常性银屑病患者皮损面积严重度指数（PASI）与骨代谢相关指标抗酒石酸酸性磷酸酶5b（TRACP-5b）、血Ca、骨碱性磷酸酶(BAP)、碱性磷酸酶（ALP）的相关性。方法对88例寻常性银屑病进行期患者进行PASI评分并分组，PASI评分≤10分为A组，10～20分为B组，≥20分为C组。采用双能X线吸收法分别检测患者腰椎、股骨颈、左前臂3个部位的骨密度（BMD）；在相同条件下检测患者血液中ALP和钙的浓度；ELSIA法检测患者血清中TRACP-5b及BAP的浓度，并进行统计学分析。结果反映骨形成指标的ALP、骨吸收指标的TRACP-5b和血Ca浓度A组和C组差异有统计学意义（P＜0.05），成骨细胞活性标志物BAP 3组比较差异无统计学意义（P＞0.05）。C组腰椎BMD分别与A、B两组相比差异有统计学意义（P＜0.05），A组股骨颈BMD与B、C两组相比差异有统计学意义（P＜0.05），而左前臂BMD 3组比较无差异（P＞0.05）。C组腰椎、股骨颈峰值骨量（T值）与A、B两组相比差异有统计学意义（P＜0.05），3组左前臂T值组间比较无差异（P＞0.05）。结论寻常性银屑病进行期患者存在骨代谢异常及骨量流失，且与PASI评分成正比。
목적：연구진행기심상성은설병환자피손면적엄중도지수（PASI）여골대사상관지표항주석산산성린산매5b（TRACP-5b）、혈Ca、골감성린산매(BAP)、감성린산매（ALP）적상관성。방법대88례심상성은설병진행기환자진행PASI평분병분조，PASI평분≤10분위A조，10～20분위B조，≥20분위C조。채용쌍능X선흡수법분별검측환자요추、고골경、좌전비3개부위적골밀도（BMD）；재상동조건하검측환자혈액중ALP화개적농도；ELSIA법검측환자혈청중TRACP-5b급BAP적농도，병진행통계학분석。결과반영골형성지표적ALP、골흡수지표적TRACP-5b화혈Ca농도A조화C조차이유통계학의의（P＜0.05），성골세포활성표지물BAP 3조비교차이무통계학의의（P＞0.05）。C조요추BMD분별여A、B량조상비차이유통계학의의（P＜0.05），A조고골경BMD여B、C량조상비차이유통계학의의（P＜0.05），이좌전비BMD 3조비교무차이（P＞0.05）。C조요추、고골경봉치골량（T치）여A、B량조상비차이유통계학의의（P＜0.05），3조좌전비T치조간비교무차이（P＞0.05）。결론심상성은설병진행기환자존재골대사이상급골량류실，차여PASI평분성정비。
Objective To investigate the correlation between PASI scores of progressive psoriasis vulgaris and the bone metabolism markers:TRACP-5b, serum calcium, BAP and ALP. Methods Eighty-eight patients with progressive psoriasis vulgairs were assessed by PASI scoring system, then divided into three groups according to the score:group A (the score ≤ 10), group B (the score between 10 and 20), and group C (the score ≥ 20). The bone density of the patients’ lumbar, femoral neck and left forearm were detected by dual energy x-ray absorptiometry respectively, the concentration of serum ALP and calcium were detected under the same condition, and the concentration of serum TRACP-5b and BAP were detected by ELSIA. Results For the concentration of bone formation markers ALP and bone resorption indicator TRACP-5b and blood calcium, there was signiifcant difference between group A and C (P<0.05);for the concentration of the osteoblast markers BAP, there was no signiifcant difference between the every two groups (P>0.05);for Lumbar spine BMD, there was signiifcant difference between the group C and the other two groups (P<0.05);for femoral neck BMD, there was signiifcant difference between the group A and the other two groups(P<0.05);for the left forearm BMD, there was no signiifcant difference between the every two groups (P<0.05);for the peak of the bone mass (T-value) of lumbar spine and femoral neck, there was signiifcant difference between group C and the other two groups (P<0.05), for the T-value of left forearm, there was no signiifcant difference (P>0.05) between the every two groups. Conclusion Abnormal bone metabolism and bone loss may occur in the patients with progressive psoriasis vulgaris, and the severity is proportional to the PASI score.