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目的 研究激素敏感型肾病综合征 (SSNS)患儿骨生化标志水平的变化特点及意义。方法 应用放射免疫分析法检测 2 4例SSNS患儿活动期和缓解期血清骨钙素 (OC)、Ⅰ型前胶原氨基端伸展肽 (PINP)、Ⅰ型胶原羧基端关联肽原 (ICTP)水平 ,与 19例年龄、性别相匹配正常对照儿童进行比较。结果 SSNS患儿活动期血OC[(11 37± 3 5 4 ) μg/L]、PINP[(339 6 4± 12 6 6 ) μg/L]和缓解期血OC[(6 6 1± 1 74 ) μg/L]、PINP[(175 71±11 97) μg/L]均低于对照组血OC[(18 4 4± 4 35 ) μg/L]、PINP[(471 30± 10 6 2 ) μg/L],分别为 P <0 0 5和P <0 0 1。活动期血ICTP[(19 0 5± 4 5 6 ) μg/L]与对照组 [(19 5 6± 3 6 2 ) μg/L]相比 ,差别无统计学意义 ,P >0 0 5 ;而缓解期血ICTP水平升高 ,P <0 0 1。活动期和缓解期血OC水平和PINP水平均呈正相关 (分别r =0 85 ,P <0 0 1和r =0 71,P <0 0 1)。结论 SSNS患儿活动期骨形成生化标志水平降低 ,骨吸收生化标志水平无变化 ;缓解期骨形成生化标志水平进一步下降 ,骨吸收生化标志水平升高。
Objective To study the characteristics and significance of the changes of bone biochemical markers in children with steroid sensitive nephrotic syndrome (SSNS). Methods Serum levels of osteocalcin (OC), type Ⅰ procollagen (PINP), type Ⅰ collagen carboxy terminal propeptide (ICTP) levels in 24 SSNS children during active phase and remission were measured by radioimmunoassay. , Compared with 19 age and sex matched normal control children. Results The levels of serum OC [(11 37 ± 3 5 4) μg / L], PINP [339 6 4 ± 12 6 6 μg / L] and remission blood OC [(6 6 1 ± 1 74 ), PINP [(175 71 ± 11 97) μg / L] were lower than those in control group (18 4 4 ± 4 35 μg / L), PINP [(471 30 ± 10 6 2) μg / L], P <0 05 and P 0 01, respectively. Compared with the control group [(196 ± 362) μg / L], there was no significant difference in ICTP [(19 05 ± 456) μg / L] in active stage, P> 0.05 The ICTP level in the remission period increased, P <0.01. There was a positive correlation between blood levels of OC and PINP in both active and remission stages (r = 0 85, P <0 01 and r 0 71, P 0 01, respectively). Conclusions The biochemical markers of bone formation in active stage of SSNS are decreased, while the biochemical markers of bone resorption are unchanged. The biochemical markers of bone formation in remission stage are further decreased and the biochemical markers of bone resorption are elevated.