Andress D L, Endres D B, Maloney N A, Kopp J B, Coburn J W, Sherrard D J
J Clin Endocrinol Metab. 1986 Nov;63(5):1163-9. doi: 10.1210/jcem-63-5-1163.
Bone biopsies were studied in 67 dialysis patients to determine if a PTH RIA specific for intact plasma PTH is a better predictor of osteitis fibrosa than a RIA that measures inactive carboxy-terminal/midregion plasma PTH fragments. An amino-terminal-specific antiserum that cross-reacts with intact PTH, but not midregion or carboxy-terminal fragments, and an antiserum that cross-reacts with the 44-68 region of the PTH molecule and measures both intact and midregion/carboxy-terminal PTH fragments were used in the comparisons. Plasma PTH concentrations measured by both assays correlated positively with bone formation rate, bone apposition rate, osteoblastic osteoid, osteoclast number, and marrow fibrosis. The optimum predictive value of the amino-terminal PTH assay for osteitis fibrosa was 88%, compared to 74% for the midregion PTH assay. This difference in predictive value could be attributed to the highly significant correlation of marrow fibrosis with plasma amino-terminal PTH. In conclusion, these data suggest that a PTH RIA that uses an amino-terminal-specific antiserum may be a better predictor of osteitis fibrosa in patients undergoing maintenance hemodialysis.
对67例透析患者的骨活检进行研究，以确定一种针对完整血浆甲状旁腺激素（PTH）的PTH放射免疫测定法（RIA）是否比一种测量无活性羧基末端/中间区域血浆PTH片段的RIA能更好地预测纤维性骨炎。在比较中使用了一种与完整PTH发生交叉反应但不与中间区域或羧基末端片段发生交叉反应的氨基末端特异性抗血清，以及一种与PTH分子的44 - 68区域发生交叉反应并能测量完整和中间区域/羧基末端PTH片段的抗血清。两种测定法测得的血浆PTH浓度均与骨形成率、骨贴附率、成骨细胞类骨质、破骨细胞数量和骨髓纤维化呈正相关。氨基末端PTH测定法对纤维性骨炎的最佳预测值为88%，而中间区域PTH测定法为74%。预测值的这种差异可归因于骨髓纤维化与血浆氨基末端PTH的高度显著相关性。总之，这些数据表明，使用氨基末端特异性抗血清的PTH RIA可能是维持性血液透析患者纤维性骨炎的更好预测指标。
