摘要目的 探讨骨特异性碱性磷酸酶(BALP)和抗酒石酸酸性磷酸酶-5b(TRAP-5b)以及Singh指数相结合预测老年髋部骨折发生的临床意义.方法 老年髋部骨折患者43例,对照组同龄健康体检人员43例,Singh指数测定:采用西门子Aristos VXPlus X光机拍摄骨盆X线片(包括骨折组和对照组),进行Singh指数的分级;骨代谢生化指标测定:采用酶联免疫(ELLSA)法测定血清BALP、TRAP-5b值.对上述实验结果应用SPSS 13.0统计软件进行统计学分析.结果 骨折组和对照组血清骨代谢指标BALP、TRAP-5b含量、Singh指数,差异有统计学意义(P＜0.05).BALP和TRAP-5b之间呈明显正相关(P＜0.05),BALP、TRAP-5b与Singh指数均呈明显负相关(P＜0.05).BALP和TRAP-5b以及Singh指数预测骨折风险敏感度分别为71.9％、57.1％、60.5％,三者联合预测骨折风险的敏感度为95.1％.结论 骨折组骨代谢生化指标BALP、TRAP-5b和Singh指数存在异常.BALP和TRAP-5b以及Singh指数相结合可以明显提高预测老年髋部骨折的敏感度,可以作为预测老年髋部骨折风险的敏感指标.

abstractsObjective In this study,comparing and analyzing the changes of the bone metabolic markers including bone-specific alkaline phosphatase (BALP),tartrate-resistant acid phosphatase 5b (TRAP-5b),and Singh index in elderly the correlations between the three predictors of BALP,TRAP-5b,and Singh index were derived,and the sensitivity and specificity of predicting hip fracture were calculated.Methods Determination of the Singh index:with the help of an experienced radiology technician and three senior orthopedic surgeons,the pelvic plain film X-ray by the Siemens Aristos Vx Plus Model X-ray machine (fracture group and the control group) were analyzed,and then the Singh index of these pelvic X-ray grading were record and the mean of Singh index was judged.Determination of markers of bone metabolism:The bone metabolic markers in serum BALP,TRAP-5b were measured by enzyme-linked immunosorbent assay (ELISA) after specimen collection before uniform.SPSS 13.0 statistical software was used to analyze all of experimental data.Results The significantly different of levels of bone metabolic markers TBALP,TRAP-5b and Singh index in fracture group and the control group (P ＜0.05).the between Bone metabolic markers BALP,and TRAP-5b is significant positive correlation (P ＜ 0.01).the between Singh index and bone metabolic markers BALP,and TRAP-5b is significant negatively correlation (P ＜0.01).Bone metabolic markers BALP,TRAP-5b,and Singh index sensitivity of 71.9％,57.1％ and 60.5％ ; and those joint diagnosis of hip fracture experimental sensitivity of 95.1％.Conclusion By comparing the levels of BALP,TRAP-5b and Singh index changes in fracture group with the control group,the bone metabolic markers including BALP,TRAP-5b,and Singh index in fracture group were found to be abnormal.Combination consideration of the bone metabolic markers BALP,TRAP-5b and Singh index to predict is of more meaningful than the single bone metabolism indicators of BALP,or TRAP-5b and Singh index in elderly hip fracture.So BALP,TRAP-5b,and Singh index combination can significantly improve the sensitivity of the prediction of hip fracture in elderly.