【作者】 高志棣；

【导师】 王潍博；

【作者基本信息】 山东大学 ， 临床医学肿瘤学， 2006， 硕士

【摘要】 目的：本文检测与分析骨转移瘤患者尿Ⅰ型胶原交联氨基末端肽（uNTX）水平，以评价其与骨转移瘤患者病情发展和疗效的关系。 方法：研究对象分为A、B、C三组。A组，正常成人组35例；B组，原发肿瘤组35例，不伴X线和／或ECT骨转移表现；C组，骨转移瘤组33例，有临床骨转移症状和X线和／或ECT骨转移表现。弃空腹第一次晨尿，然后用uNTX试剂盒测定清晨空腹第二次尿NTX水平，同时检测血清AKP活性和Ca²⁺浓度，用于比较和分析。C组32例治疗后10～12周作了uNTX的随访观察，其中30例进行了治疗前后对比。 结果：A组uNTX水平（43.74±28.70pmolBCE／umolCr）与B组（47.33±22.88pmolBCE／umolCr）比较无显著性差异（P＞0.05）；C组uNTX水平（89.08±33.98pmolBCE／umolCr）明显升高，与A、B两组比较，均有显著性差别（P＜0.01）。18例骨转移瘤患者治疗前后 uNTX水平（90.21±50.19；65.29±43.43）也有显著性差异（P＜0.01）。C组中uNTX水平、血清AKP活性和Ca²⁺浓度升高率分别为 5％、55％和45％。 结论：UNTX是尿中稳定的骨质溶解最终产物，是特异性反映骨溶解的标志物。骨转移时uNTX水平会发生异常，uNTX水平与骨转移的发生呈正相关，亦与骨转移灶的数量呈正相关，广泛骨转移时升高显著。UNTX敏感度高于血清AKP活性和Ca²⁺浓度，变化早于影像学检查。因此，uNTX水平在鉴别骨转移瘤更多还原

【Abstract】 Objective To measure and analyse the significance of urinary type I collagen cross-linked N-telopeptides(uNTX) in the evaluation of prognosis, response to therapy of bone metastatic neoplasms.Methods Subjects were divided into 3 groups.Group A is composed of 35 healthy adult people.Group B is composed of 35 primary tumor patients without bone metastatic neoplasms proofed by x-ray or emission computer tomography(ECT).GroupC is composed of 33 patients with bone metastasis proofed by x-ray or ECT. Measurement of uNTX were made by test kit of uNTX, while measurement of activity of serum alkaline phosphatases(AKP)and calcium concentration were made.Result There were no significant difference of uNTX between Group A and Group B(p>0.05).There were significant difference of uNTX between Group A and Group B,Group C (p<0.01).There were significant difference of uNTX between pretherapy and posttherapy. The rising rate of uNTX,AKP and plasma calcium concentration was 85%、 55%和P 45 %.Conclusions UNTX is a specifically sensitive maker of bone collagen turnover. UNTX has positive correlation with bone metastasis neoplasms. It is marked high while patients have extensive bone collagen breakdown and more sensitive than activity of serum AKP and plasma calcium concentration. It更多还原