骨质疏松标志物在评价类风湿关节炎骨代谢及侵蚀作用的临床研究

目的：探讨I型胶原交联羧基氨基端肽(beta-Crosslaps)和总骨1 型前胶原氨基端延长肽（P1NP）及C- 反应蛋白（CRP）在类风湿 性关节炎骨质疏松发生与骨侵蚀程度评价中的作用。方法：运用电化学发光法对茁-Cross Laps、P1NP进行定量检测。用胶乳散射 比浊法进行CRP 定量检测。将65 例类风湿关节炎患者按有无骨质破坏分为早期组和非早期组，按活动性分为缓解组与活动组， 按骨影像学显示分为骨侵蚀组与非骨侵蚀组。并取30 例健康体检者作为对照组。结果：三种标志物在早期RA 组与非早期RA 组 之间及在活动组与缓解组、骨侵蚀组与非骨侵蚀组比较具有显著差异，差异有统计学意义（P<0.01）。结论：beta-Cross laps、P1NP、 CRP三种骨质疏松标志物可以用作评价RA骨代谢水平和骨侵蚀程度的良好指标，并还可以运用于疗效监测，有较好的临床应用价 值。

Osteoporosis Markers in the Clinical Evaluation of Bone Metabolismand Erosion in Rheumatoid Arthritis

Objective:To discuss the clinical value of applying the beta-Crosslaps, P1NP and CRP in estimating the occurrence of osteoporosis and bone eroding in rheumatoid arthritis (RA).Methods:The levels of beta-Crosslaps, P1NP, CA15-3 were examined by the electrochemi-luminescence method, and the concentration of CRP was detected by latex nephelometry. 65 RA patients and 30 healthy volunteers were enrolled in this study. RA patients were divided into early stage group and non-early group, bone erosion group and non-bone erosion group, bone erode group and non-bone erode group according to the bone destruction, the bone imaging and the results of bone imageology respectively.Results:The levels of these three markers were significantly different among these groups according to the three classification methods (P<0.01).Conclusion:The concentrations of beta-Crosslaps,P1NP and CRP might be potential biomarkers for evaluating bone metabolism and bone eroding in RA. And they could be used as a therapeutic monitor with an excellence clinical application value.