摘要目的 分析青海省大骨节病病区人群尿中生物标志物羟脯氨酸(HYP)和Ⅱ型胶原羧基端肽(CTX-Ⅱ)含量,为成人大骨节病防治工作提供依据.方法 根据《大骨节病诊断》(WS/T 207-2010),采用病例-对照研究方法,在青海省大骨节病病区选取大骨节病患者120人(病例组,男性55例、女性65例),健康成人89人(对照组,男性41例、女性48例),采集晨尿,使用酶联免疫吸附试验(ELISA)法检测两组人群尿中HYP和CTX-Ⅱ含量,检测结果用肌酐含量校正.采用SPSS 17.0软件进行数据统计分析.结果 病例组和对照组男、女性年龄比较差异无统计学意义(t=1.813、1.131,P均＞0.05).男性大骨节病患者尿中HYP、CTX-Ⅱ含量中位数为74.91 μg/μmol Cr、630.77 ng/μ mol Cr,与同性别对照组(51.38 μg/μmol Cr、401.32 ng/μ mol Cr)比较,差异有统计学意义(Z=3.068、3.246,P均＜0.01);女性大骨节病患者尿中HYP、CTX-Ⅱ含量中位数为91.07 μg/μmol Cr、637.17 ng/μmol Cr,与同性别对照组(88.37 μg/μmol Cr、546.47 ng/μmol Cr)比较,HYP含量差异无统计学意义(Z=0.273,P＞ 0.05),而CTX-Ⅱ含量差异有统计学意义(Z=2.002,P＜0.05).结论 大骨节病男性患者尿中HYP含量变化明显;而男、女性患者Ⅱ型胶原的降解均增多,CTX-Ⅱ能反映大骨节病的胶原代谢改变.

abstractsObjective To detect urinary bio-markers of hydroxyproline (HYP) and c-terminal telopeptide of collagen type Ⅱ (CTX-Ⅱ) among population from Kashin-Beck disease (KBD) regions in Qinghai Province,and to provide the scientific data for prevention and control of adult KBD.Methods According to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010),using case-control study,120 KBD patients (males 55,females 65) and 89 healthy controls (males 41,females 48) in Qinghai KBD regions were divided into case group and control group.Morning urine samples were collected.HYP and CTX-Ⅱ contents were analyzed by enzyme-linked immunosorbent assay (ELISA),then these results were corrected with creatinine.All the data were analyzed by SPSS 17.0 software.Results There was no significant difference in the age of male and female between case group and control group (t =1.813,1.131,P ＞ 0.05).The medians of urinary HYP and CTX-Ⅱ contents among male patients were 74.91 μg/μmol Cr and 630.77 ng/μmol Cr,respectively,which were higher than those of control groups (51.38 μg/μ mol Cr,401.32 ng/μmol Cr,Z =3.068,3.246,P ＜ 0.01).The medians of urinary HYP and CTX-Ⅱ contents among female patients were 91.07 μg/μmol Cr and 637.17 ng/μmol Cr,respectively,compared with those of control groups (88.37μg/μmol Cr,546.47 ng/μmol Cr),there was no significant difference in HYP content (Z =0.273,P ＞ 0.05),however,the difference in CTX-Ⅱ content was statistically significant (Z =2.002,P ＜ 0.05).Conclusion The urinary HYP contents of male patients with KBD change significantly,while the degradation of type Ⅱ collagen in male and female patients increases,and CTX-Ⅱ could reflect the metabolic changes of collagen in KBD.