【摘要】 目的观察60例强直性脊柱炎(ankylosing spondylitis,AS)患者血清骨钙蛋白(bone gla protein,BGP)、抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRACP)的变化并进行相关性分析。方法将60例强直性脊柱炎患者列为实验组,另设30例正常健康人为对照组,观察两组BGP、TRACP的变化,并分析其与年龄、病程、视觉模拟评分(visual analog scale,VAS)、Bath强直性脊柱炎活动指数(Bath ankylosing spondyli-tis disease active index,BASDAI)、Bath强直性脊柱炎功能指数(Bath ankylosing spondylitis functional in-dex,BASFI)、Bath强直性脊柱炎整体指数(Bath ankylosing spondylitis global index,BAS-G)、情绪和血沉(erythrocyte sedimentation rate,ESR)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、α酸性糖蛋白(α-AGP)、调节性T细胞(regulatory T cells,Treg)、中医证候积分的相关性;同时观察实验组在不同疾病活动状态下BGP、TRACP的变化情况。结果①与对照组比较,实验组TRACP水平显著升高,BGP水平显著降低(P<0.05,或P<0.01);②按病情活动性分组,BASDAI>4组的TRACP水平显著高于BASDAI≤4组,而BGP水平显著低于BASDAI≤4组(P<0.01)。③pearson相关性分析表明,AS患者血清BGP水平与年龄、病程、VAS、BASDAI、BASFI、BAS-G、ESR、CRP和中医证候积分呈负相关性(P<0.05,或P<0.01),与CD4+CD25+Treg、CD4+CD25+CD127-Treg百分比呈正相关性(P<0.05,或P<0.01);AS患者血清TRACP水平与年龄、病程、VAS、BASDAI、BASFI、BAS-G、ESR、CRP和中医证候积分呈正相关性(P<0.05,或P<0.01),与CD4+CD25+Treg、CD4+CD25+CD127-Treg百分比呈负相关性(P<0.05,或P<0.01)。结论 AS患者BGP显著降低,TRACP显著升高,并与其年龄、病程、临床症状体征、疾病活动、CD4+CD25+Treg、CD4+CD25+CD127-Treg百分比密切相关,提示AS患者骨代谢表现为骨形成减少、骨吸收增加,且受到年龄、病程、免疫炎症反应、疾病活动影响,从而出现一系列临床症状和体征。更多还原

【Abstract】 Objective To observe the changes of serum bone gla protein(BGP) and tartrate-resistant acid phosphatase(TRACP) on bone metabolism in sixty patients with ankylosing spondylitis(AS) and analyse the relative influencing factors.Methods Sixty AS patients were enrolled as experiment group and thirty healthy people were included in control group.The level changes of BGP and TRACP of the two groups were observed,and their correlation with related factors were analyzed,including age,course of disease,visual analog scale(VAS),Bath ankylosing spondylitis disease active index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),Bath ankylosing spondylitis global index(BAS-G),erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP),α-acid glycoprotein(α-AGP),regulatory T cells(Treg),and scores of traditional Chinese medicine syndrome.Meanwhile,the changes of BGP and TRACP in the treatment group were observed during different disease active stage of AS.Results(1)Compared with those in the control group,the levels of TRACP in the treatment group were increased significantly,while the levels of BGP were significantly decreased(P<0.05,or P<0.01).(2) Sixty AS patients were divided into two subgroups based on BASDAI,the levels of TRACP in BASDAI>4 subgroup were significantly higher than those in BASDAI≤4 subgroup,while the levels of BGP were significantly lower than those in BASDAI≤4 subgroup(P<0.01).(3)Pearson correlation analysis revealed that the levels of BGP were correlated negatively with age,course of disease,VAS,BASDAI,BASFI,BAS-G,ESR,hs-CRP,and the scores of traditional Chinese medicine syndrome(P<0.05,or P<0.01),while they were correlated positively with the percentage of CD4+CD25+ Treg and CD4+CD25+CD127-Treg(P<0.05,or P<0.01).The levels of TRACP were correlated positively with age,course of disease,VAS,BASDAI,BASFI,BAS-G,ESR,hs-CRP,and the scores of traditional Chinese medicine syndrome,while they were correlated negatively with the percentage of CD4+CD25+ Treg and CD4+CD25+ CD127-Treg(P<0.05,or P<0.01).Conclusion In patients with AS,the levels of BGP are significantly decreased,and the levels of TRACP are significantly increased,both of which have a close correlation with age,course of disease,clinical symptoms and signs,disease activity,and the percentage of CD4+CD25+ Treg and CD4+CD25+ CD127-Treg.It is suggested that the decrease in bone formation and increase in bone loss are the manifestations of bone metabolism of AS patients,which is affected by age,the course of disease,immune inflammatory reaction,and disease activity,resulting a series of clinical symptoms and signs.更多还原