Beyeler C, Banks R E, Thompson D, Forbes M A, Cooper E H, Bird H
Department of Rheumatology, University of Berne, Switzerland.
Ann Clin Biochem. 1995 Jul;32 ( Pt 4):379-84. doi: 10.1177/000456329503200405.
A double monoclonal immunoradiometric assay specific for bone alkaline phosphatase (BAP) was used to determine whether the raised total alkaline phosphatase (TAP) often found in patients with active rheumatoid arthritis (RA) and ankylosing spondylitis (AS) is derived from bone or liver. Fifty-eight patients with RA were compared to 14 with AS and 14 with non-inflammatory rheumatic diseases (NI). None had clinical liver disease and only one had a slightly elevated aspartate transaminase activity. Elevated BAP concentrations were found in seven patients (5 RA, 1 AS, 1 NI), only two of whom also had abnormal TAP. Abnormal TAP activities were found in only three patients (all RA). BAP did not correlate with disease activity in RA or AS. In contrast, TAP correlated with disease activity (assessed by plasma viscosity) in RA (P < 0.002) and gamma-glutamyl transferase (GGT) also correlated with plasma viscosity in RA (P < 0.01). Both TAP and BAP were significantly correlated with GGT in RA (P < 0.001 and P < 0.02, respectively). These findings are discussed, together with possible reasons for the conflicting nature of some of the observations.
采用一种针对骨碱性磷酸酶（BAP）的双单克隆免疫放射分析方法，以确定在活动性类风湿关节炎（RA）和强直性脊柱炎（AS）患者中经常发现的总碱性磷酸酶（TAP）升高是源自骨骼还是肝脏。将58例RA患者与14例AS患者以及14例非炎性风湿性疾病（NI）患者进行比较。所有患者均无临床肝病，只有1例天冬氨酸转氨酶活性略有升高。7例患者（5例RA、1例AS、1例NI）的BAP浓度升高，其中只有2例TAP也异常。仅3例患者（均为RA）的TAP活性异常。BAP与RA或AS的疾病活动度无关。相比之下，RA患者中TAP与疾病活动度（通过血浆粘度评估）相关（P < 0.002），γ-谷氨酰转移酶（GGT）也与RA患者的血浆粘度相关（P < 0.01）。RA患者中TAP和BAP均与GGT显著相关（分别为P < 0.001和P < 0.02）。对这些发现进行了讨论，并探讨了一些观察结果相互矛盾的可能原因。
