本文關(guān)鍵詞： 骨質(zhì)疏松 骨標(biāo)志物 絕經(jīng)后女性 2型糖尿病 甲襞微循環(huán)　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討絕經(jīng)后女性2型糖尿病患者的骨密度、骨標(biāo)志物水平及甲襞微循環(huán)狀況,為早期發(fā)現(xiàn)、早期預(yù)防絕經(jīng)后2型糖尿病婦女罹患骨質(zhì)疏松癥及指導(dǎo)治療提供參考依據(jù)。方法:選擇2014年12月~2016年3月在309醫(yī)院骨內(nèi)科住院的絕經(jīng)后女性患者128例,其中60例為2型糖尿病患者,定為研究組,年齡50-69歲,平均年齡60.8歲;無糖尿病者68例,定為對(duì)照組,年齡50-69歲,平均年齡59.8歲,采用美國好樂杰公司雙光能骨密度儀測(cè)量所有患者進(jìn)行腰椎L2-L4和左側(cè)股骨近端及全髖骨密度,采用微循環(huán)檢測(cè)儀(徐州眾聯(lián)醫(yī)療器械有限公司)對(duì)所有患者進(jìn)行甲襞微循環(huán)檢測(cè),并測(cè)量其身高及體重,記錄其入院時(shí)生化血脂,血鈣、磷、鎂、空腹血糖情況,采用酶聯(lián)免疫吸附法測(cè)定各組的B-ALP、TRAP5b、PINP、25羥維生素D的水平,比較兩組間骨密度值、生化指標(biāo)及骨標(biāo)志物水平、甲襞微循環(huán)是否存在統(tǒng)計(jì)學(xué)差異。然后將所有研究對(duì)象按骨密度情況分為三組,其中骨質(zhì)疏松45例,年齡51-69歲,平均年齡61.5歲;骨量減少45例,年齡50-69歲,平均年齡59.4歲;正常骨密度38例,年齡50-69歲,平均年齡58.8歲;比較三組間的生化指標(biāo)、骨標(biāo)志物水平及甲襞微循環(huán)是否存在統(tǒng)計(jì)學(xué)差異。結(jié)果:糖尿病組與對(duì)照組間一般情況如年齡、身高、體重、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、血鎂、血脂水平無統(tǒng)計(jì)學(xué)差異,兩組髖部及腰1-4椎體骨密度水平、25羥維生素D及PTH無統(tǒng)計(jì)學(xué)差異。糖尿病組空腹血糖、血鈣水平、TRAP-5b、甲襞微循環(huán)形態(tài)積分及總積分高于對(duì)照組,而OC、ALP值比對(duì)照組降低,差異顯著(P0.05)。pearson相關(guān)分析研究發(fā)現(xiàn),骨轉(zhuǎn)換標(biāo)志物OC、TRAP、B-ALP與骨密度值呈負(fù)相關(guān)趨勢(shì),且有統(tǒng)計(jì)學(xué)意義(P0.05);特別是TRAP-5b及OC與骨密度值相關(guān)性良好。將所有研究對(duì)象分為骨質(zhì)疏松組、骨量減少組、正常骨密度三組后發(fā)現(xiàn),三組之間在一般情況(年齡、身高、體重、BMI)及血生化指標(biāo)(Ca、P、Mg、GLU、TG、總膽固醇、HDL-C、LDL-C)、微循環(huán)加權(quán)積分值方面不存在統(tǒng)計(jì)學(xué)差異(P0.05),骨質(zhì)疏松組與骨密度正常組在酒石酸酸性膦酸酶(TRAP5b)、骨鈣素(OC)水平存在統(tǒng)計(jì)學(xué)差異,骨量減少組與骨密度正常組在骨鈣素(OC)水平上存在統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:絕經(jīng)后2型糖尿病婦女骨轉(zhuǎn)換標(biāo)志物異常,可能是預(yù)測(cè)糖尿病性骨質(zhì)疏松的一個(gè)標(biāo)志。骨量減少患者在進(jìn)行預(yù)防骨質(zhì)疏松治療時(shí),應(yīng)重視抑制破骨細(xì)胞活性治療,同時(shí)注意改善微循環(huán)的狀況。
[Abstract]:Objective: to investigate the bone mineral density (BMD), bone marker level and nailfold microcirculation in postmenopausal women with type 2 diabetes. Early prevention and treatment of osteoporosis in postmenopausal type 2 diabetic women. Methods:. A total of 128 postmenopausal female patients were selected from December 2014 to March 2016 in Department of Osteology, 309 Hospital. Among them, 60 patients with type 2 diabetes mellitus were selected as study group, aged 50-69 years, with an average age of 60.8 years. 68 cases without diabetes mellitus were selected as control group, aged 50-69 years, with an average age of 59.8 years. The lumbar L2-L4 and left femur proximal and total hip bone density were measured with the dual optical energy bone mineral density (BMD). All the patients were examined by microcirculation tester (Xuzhou Zonglian Medical Instruments Co., Ltd), and their height and weight were measured, and the biochemical blood lipid, blood calcium, phosphorus and magnesium were recorded when they were admitted to hospital. Fasting blood glucose levels were measured by enzyme linked immunosorbent assay (Elisa) and bone mineral density (BMD) was compared between the two groups. Biochemical indexes and bone markers, nailfold microcirculation were statistically different. Then all the subjects were divided into three groups according to BMD, 45 cases of osteoporosis, age 51 to 69 years old. Average age 61.5 years; The bone mass was reduced in 45 cases, aged 50-69 years, with an average age of 59.4 years. Normal bone mineral density (BMD) was found in 38 cases, aged 50-69 years, with an average age of 58.8 years. The biochemical indexes, bone markers and nailfold microcirculation were compared between the three groups. Results: the general conditions of diabetes group and control group such as age, height, weight, total cholesterol. There was no significant difference in high density lipoprotein cholesterol, low density lipoprotein cholesterol, serum magnesium and blood lipid levels between the two groups. 25 hydroxyvitamin D and PTH had no statistical difference. The fasting blood glucose, serum calcium level and total score of nail fold microcirculation in diabetic group were higher than those in control group. The ALP value was significantly lower than that of the control group, and the correlation analysis showed that the bone turnover marker OCTRAPAPB-ALP was negatively correlated with bone mineral density (BMD). And there was statistical significance (P0.05). In particular, TRAP-5b and OC had good correlation with BMD. All the subjects were divided into three groups: osteoporosis group, osteopenia group, normal BMD group and normal BMD group. Height, body weight (BMIs) and blood biochemical indexes (Ca-Pu, MgGLU, TG, HDL-C, LDL-C). There was no significant difference in the weighted integral value of microcirculation between osteoporosis group and normal bone mineral density group (TRAP5b). Osteocalcin (OC) levels were significantly different. There was significant difference in osteocalcin (OC) level between the osteopenia group and the normal bone density group (P 0.05). Conclusion: the markers of bone turnover in postmenopausal women with type 2 diabetes are abnormal. It may be a marker for predicting diabetic osteoporosis. In the treatment of osteoporosis prevention, we should pay attention to the inhibition of osteoclast activity and the improvement of microcirculation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R580

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 寧佩珊;程勛杰;張林;張偉;胡國清;;1990-2010年中國人群傷害死亡率變化分析[J];中華流行病學(xué)雜志;2015年12期

2 陳紅;徐霖;吳立兵;劉剛;萬華兵;;糖皮質(zhì)激素治療SLE對(duì)骨代謝標(biāo)志物的影響分析[J];標(biāo)記免疫分析與臨床;2015年10期

3 應(yīng)大文;劉芳;;糖尿病與骨質(zhì)疏松的相關(guān)性研究進(jìn)展[J];實(shí)用預(yù)防醫(yī)學(xué);2015年10期

4 楊永紅;林明春;夏鳳瓊;張宇杰;魯力;帥小明;;骨標(biāo)志物OC、CTX-1、BAP、tP1NP的檢測(cè)在骨質(zhì)疏松癥中的臨床應(yīng)用[J];中外醫(yī)學(xué)研究;2015年27期

5 王亞春;孫紹騫;王銳;楊玉輝;;雌激素和骨標(biāo)志物與絕經(jīng)后婦女骨質(zhì)疏松的關(guān)系[J];中國婦幼保健;2015年27期

6 董松;崔立芹;雷蕾;張熙洋;蔣秋明;;2型糖尿病并發(fā)骨質(zhì)疏松的相關(guān)危險(xiǎn)因素[J];武警醫(yī)學(xué);2015年08期

7 王金華;石紅衛(wèi);;絕經(jīng)后女性骨標(biāo)志物與骨質(zhì)疏松癥的相關(guān)性研究[J];中國婦幼保健;2015年17期

8 李躍華;;補(bǔ)腎健脾活血法治療骨質(zhì)疏松癥的機(jī)制研究[J];老年醫(yī)學(xué)與保健;2015年02期

9 張智海;劉忠厚;石少輝;李艷寧;;中國大陸地區(qū)以-2.5SD為診斷的骨質(zhì)疏松癥發(fā)病率文獻(xiàn)回顧性研究[J];中國骨質(zhì)疏松雜志;2015年01期

10 沈瑩;陸雷群;高平;陳玲;;老年2型糖尿病患者骨密度與骨代謝標(biāo)志物的相關(guān)性[J];海南醫(yī)學(xué);2014年24期

，

本文編號(hào)：1470296