【摘要】 目的:通过观察绝经后骨质疏松症(PMO)患者血清E2、IL-6及IGF-Ⅰ含量的变化,探讨E2、IL-6及IGF-Ⅰ在绝经后骨质疏松症发病机理中的作用。方法:根据腰椎骨密度(BMD)扫描结果,将受试者分为三组,即绝经后骨质疏松组32例、绝经后非骨质疏松组30例、绝经前健康组30例。采用放免法测定血清IL-6、BGP、IGF-Ⅰ水平,用化学发光免疫分析法测定血清E2水平,同时测定血清P、Ca、AKP水平。结果:绝经后妇女血清IL-6水平高于绝经前妇女,骨质疏松组又高于非骨质疏松组。IL-6与BMD、E2呈负相关关系(r分别为-0.587、-0.438,P<0.05),与BGP呈正相关关系(r=0.545,P<0.05)。绝经后妇女IGF-Ⅰ含量降低,骨质疏松组IGF-Ⅰ含量最低。IGF-Ⅰ与BMD、E2呈显著正相关关系(相关系数r分别为0.569、0.433,P<0.01),与年龄呈显著负相关关系(r=-0.538,P<0.01)。结论:绝经后骨质疏松为高转换率骨质疏松,IL-6高表达与骨质疏松症发病以及雌激素减少有关,雌激素水平下降可导致IL-6分泌的增多。体内雌激素还有助于维持IGF-Ⅰ的水平,绝经后骨质疏松患者体内IGF-Ⅰ水平明显下降。IL-6分泌增多、IGF-Ⅰ水平下降均可以导致骨吸收超过骨形成,引起骨丢失和骨质疏松症的发生。因此,IL-6、IGF-Ⅰ可作为一种预测骨质疏松症发病的检测手段。合理应用雌激素、IGF-Ⅰ可预防绝经后骨质疏松症的发生。更多还原

【Abstract】 Objective To study the changes of serum levels of E₂,IL-6,IGF-Ⅰ in patients with post-menopausal osteoporosis（PMO）.Methods Serum levels of E₂（with CLIA）,IL-6,IGF-Ⅰ,BGP（with RIA） were measured in the following subjects: ① 32 patients with PMO ② 32 post-menopausal women without PMO and ③ 30 pre-menopausal controls.Serum P,Ca and AKP levels were also determined.Results As a whole,serum levels of IL-6 in postmenopausal women were higher than those in controls.Levels in subjects with PMO were significantly higher than those without PMO（P<0.05）.IL-6 levels were positively correlated with levels of BGP（r=0.545,P<0.05） and negatively correlated with levels of E₂ and BMD index（r=-0.587,-0.438 respectively,P<0.05）.On the contrary,serum IGFⅠ levels were lowest in women with PMO（vs levels in women without PMO,P<0.05）.IGF-Ⅰ levels were positively correlated with E₂ and BMD index（r=0.569,0.433 respectively,P<0.01）,and negatively correlated with age（r=-0.538,P<0.01）.Conclusion Post-menopausal osteoporosis（PMO） is associated with high tmnover of bone material and osteoclastic predominence.The decrease of E₂ levels will in someway promote the expression of IL-6（osteoclastic） and reduce the expression of IGF-Ⅰ（osteoclastic）,resulting in lessening of bone mass.HRT,despite of the controversy over cardio-vascalar safety,is beneficial for osteoporosis.更多还原