中老年人血清P1NP的浓度再分析及临床价值探讨

乔法敏，江梅，狄长春，周国胜

（焦作市第二人民医院核医学科，河南 焦作，454100）

浏览次数：914次 下载次数：343次

摘要：

目的 分析焦作地区中老年人群血清I型原胶原氨基端前肽（P1NP）水平，制定正常参考值范围，探讨检测血清P1NP 的临床意义。方法 采用放免法检测483 例中老年人血清P1NP 值，计算95%正常值参考范围，并按照血清P1NP浓度水平高低分组。根据年龄大小对中老年人群分组，比较各年龄组间血清P1NP 水平。结果 放射免疫法检测健康中老年的血清P1NP值为（41.75±17.49）ng/mL，95%正常值参考范围为17.53～86.04 ng/mL。中老年血清P1NP浓度水平高低分为骨转换正常、轻度升高、中度升高、重度（异常）升高。各年龄组的血清P1NP值中，50～54岁组血清P1NP值最高，与40～44岁组、45～49岁组、55～59岁组、<69 岁组比较，差异有统计学意义（P=0.001、P=0.000、P=0.035、P=0.002）。结论 中老年人的血清P1NP正常参考值范围为17.53～86.04 ng/mL。P1NP是骨形成敏感指标，能帮助临床判断骨转换情况，对较早提示中老年人发生骨质疏松风险有参考价值。

关键词：I型原胶原氨端前肽；中老年人；正常参考值；骨质疏松

中图分类号：R580文献标志码：A文章编号：2096-1413(2017)01-0090-02

参考文献：
[1] LI M,Li Y,DENG WM,et al.Chinese Bone Turnover Marker Study: reference ranges for c-terminal telopeptideof type I collagen and procollagen I N-terminal peptide by age and gender[J].PLoS One,2014,9(8): e103841.
[2] GARNERO P.New developmen ts in biological markers of bone meta-bolism in osteoporosis[J].Bone,2014,66(9):46-55.
[3] 范光磊,万仁明,彭鸣亚,等.癌胚抗原、糖类抗原15-3 及骨转换生化标志物检测对乳腺癌骨转移的诊断意义[J].中华核医学与分子影像杂志,2013,33(3):203-206.
[4] 中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南(2011 年)[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.
[5] CHUBB SA,BYRNES E,MANNING L,et al.Reference intervals for bone turnover markers and their association with incident hip fractures in older men: the health in men study[J].J Clin Endocrinol Metab,2015, 100(1):90-99.
[6] JOHANSSON H,OD佴N A,KANIS JA,et al.A Meta-analysis of reference markers of bone turnover for prediction of fracture[J].Calcif Tissue Int,2014,94(5):560-567.
[7] 乔法敏.966 例40 岁以上健康体检者血清P1NP 检测结果分析[J]. 山东医药,2015,55(15):105.
[8] KREGE JH,LANE NE,HARRIS JM,et al.PINP as a biological response marker during teriparatide treatment for osteoporosis [J].Osteoporos Int,2014,25(9):2159-2171.
[9] DELMAS PD,MUNOZ F,BLACK DM,et al.Effects of yearly zoledronic acid 5 mg on bone turnover markers and relation of PINP with fracture reduction in postmenopausal women with osteoporosis [J].J Bone Miner Res,2009,24(9):1544-1551.
[10] LI M,ZHANG ZL,LIAO EY,et al.Effect of low -dose alendronate treatment on bone mineral density and bone turnover markers in Chinese postmenopausal women with osteopenia and osteoporosis [J].Menopause, 2013,20(1):72-78.
[11] EASTELL R,ROGERS A,NI X,et al.Effects of raloxifene and alendronate on bone turnover as assessed by procollagen type I N-terminal propeptide[J].Osteoporos Int,2011,22(6):1927-1934.
[12] QUESADA-G佼MEZ JM,MUSCHITZ C,GMEZ-REINO J,et al.The effect of PTH (1-84) or strontium ranelate on bone formation markers in postmenopausal women with primary osteoporosis: results of a randomized, open-label clinical trial[J].Osteoporos Int,2011,22(9):2529-2537.

[13] LANGDAHL BL,TEGLBJAERG CS,HO PR,et al.A 24-month study evaluating the efficacy and safety of denosumab forthe treatment of men with low bone mineral density:results from the ADAMO trial[J].J Clin Endocrinol Metab,2015,100(4):1335-1342.
[14] DONGMEI N,IKI M,TAMAKI J,et al.Association between weight changes and changes in hip geometric indices inthe Japanese female population during 10-year follow-up: japanese population-based osteoporosis(JPOS) cohort study[J].Osteoporos Int,2012,23(5):1581-1591.