Komemushi Atsushi, Tanigawa Noboru, Kariya Shuji, Kojima Hiroyuki, Shomura Yuzo, Tokuda Takanori, Nomura Motoo, Terada Jiro, Kamata Minoru, Sawada Satoshi
Department of Radiology, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan.
Cardiovasc Intervent Radiol. 2008 Mar-Apr;31(2):332-5. doi: 10.1007/s00270-007-9246-8. Epub 2007 Dec 12.
To evaluate relationships between biochemical markers of bone turnover, bone mineral density, and new compression fractures following vertebroplasty.
Initially, we enrolled 30 consecutive patients with vertebral compression fractures caused by osteoporosis. Twenty-three of the 30 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. The patients were divided into two groups: patients with new fractures (group F) and patients with no new fractures (group N). We analyzed differences in the following parameters between these two groups: serum bone alkaline phosphatase, urinary crosslinked N-telopeptide of type I collagen, urinary deoxypyridinoline, and bone mineral density. Next, the patients were divided into another two groups: patients with higher risk (group H: urinary crosslinked N-telopeptide of type I collagen >54.3 nmol BCE/mmol Cr or urinary deoxypyridinoline >7.6 nmol/mmol Cr, and serum bone alkaline phosphatase <29.0 U/l) and patients with lower risk (group L). We analyzed the difference in the rate of new fractures between these two groups.
We identified 9 new fractures in 7 patients. There were no significant differences between groups F and N. We identified 5 new fractures in 3 of the 4 patients in group H, and 4 new fractures in 4 of the 19 patients in group L. There was a significant difference in the rate of new fractures between groups H and L.
A combination of high levels of bone resorption markers and normal levels of bone formation markers may be associated with increased risk of new recurrent fractures after percutaneous vertebroplasty.
评估椎体成形术后骨转换生化标志物、骨密度与新发压缩性骨折之间的关系。
最初，我们纳入了30例因骨质疏松导致椎体压缩性骨折的连续患者。30例患者中有23例在椎体成形术后4周以上到我院进行随访检查。患者被分为两组：新发骨折患者（F组）和无新发骨折患者（N组）。我们分析了两组之间以下参数的差异：血清骨碱性磷酸酶、尿I型胶原交联N端肽、尿脱氧吡啶啉和骨密度。接下来，患者又被分为另外两组：高风险患者（H组：尿I型胶原交联N端肽>54.3 nmol BCE/mmol Cr或尿脱氧吡啶啉>7.6 nmol/mmol Cr，且血清骨碱性磷酸酶<29.0 U/l）和低风险患者（L组）。我们分析了两组之间新发骨折发生率的差异。
我们在7例患者中发现了9处新发骨折。F组和N组之间无显著差异。我们在H组的4例患者中的3例中发现了5处新发骨折，在L组 的19例患者中的4例中发现了4处新发骨折。H组和L组之间新发骨折发生率存在显著差异。
骨吸收标志物水平高与骨形成标志物水平正常相结合，可能与经皮椎体成形术后新发复发性骨折的风险增加有关。
