Stĕpán J, Kolár J, Stĕpán J, Susta A
Z Rheumatol. 1977 Mar-Apr;36(3-4):120-5.
Coinciding investigations of the 85Sr test and of bone derived serum alkaline phosphatases activity were undertaken in 38 patinets with locomotor system diseases. In 15 patients there was congruence between the positive result of the 85Sr test and an increased activity of B-ALP. In 5 patients there was congruence between negative outcome of B-ALP and negative 85Sr test. The activities of T-ALP, B-ALP, L-ALP and I-ALP were compared with a group of 124 healthy controls. The causes of 18 incongruent results were analysed. In rhizomelic form of ASp, active Paget's disease, osteomalacia and in some forms of osteoporosis there was congruence between increased activity of B-ALP and the positive 85Sr test over the clinically involved area of the locomotor system. In ankylosing spondylitis (without rhizomelic involvement) there may be a moderate fall of B-ALP activity but the 85Sr test is usually positive; this may correspond with metabolic activity in the paravertebral region of the ligaments. Low B-ALP activity and positive 85Sr test in MP may refer to a latent process in the bone apparatus without marked activity of osteoblasts. The fall of B-ALP may be a result of therapy or due to the reduced capacity of B-ALP to be released from the bone. In osteomalacia the rapid fall of 85Sr activity during the test is the cause by the presence of pathological osteoid which may be, even in patients with hypertension, of renal origin. A method was described permitting the evaluation of the process of active incorporation of bone minerals (after 8 days). The activity of the 85Sr test over clinically silent areas (e.g. spine) may indicate a decompensated process in the spine due to an involvement to the large joints. The two methods used in this study are metabolically different (85Sr binds to proteoglycans and inorganic structures of bone tissue, alkaline phosphatase to the activity of osteoblasts) and prove to be clinically valuable. Detailed analysis of the results makes it possible to define the stages of clinical activity of disease and to check more exactly the efficiency of the therapeutic method.
对38例运动系统疾病患者同时进行了85锶试验和骨源性血清碱性磷酸酶活性的研究。15例患者85锶试验阳性结果与B-ALP活性升高相符。5例患者B-ALP阴性结果与85锶试验阴性相符。将T-ALP、B-ALP、L-ALP和I-ALP的活性与124名健康对照者组成的一组进行了比较。分析了18例不一致结果的原因。在臀肌型ASp、活动期佩吉特病、骨软化症和某些类型的骨质疏松症中，B-ALP活性升高与运动系统临床受累区域85锶试验阳性相符。在强直性脊柱炎（无臀肌受累）中，B-ALP活性可能有中度下降，但85锶试验通常为阳性；这可能与韧带椎旁区域的代谢活性相对应。MP中B-ALP活性低且85锶试验阳性可能指骨装置中的潜在过程，成骨细胞无明显活性。B-ALP下降可能是治疗的结果，也可能是由于B-ALP从骨中释放的能力降低。在骨软化症中，试验期间85锶活性的快速下降是由于存在病理性类骨质，即使在高血压患者中，其也可能源自肾脏。描述了一种允许评估骨矿物质活性掺入过程（8天后）的方法。85锶试验在临床无症状区域（如脊柱）的活性可能表明由于大关节受累导致脊柱失代偿过程。本研究中使用的两种方法在代谢上不同（85锶与骨组织的蛋白聚糖和无机结构结合，碱性磷酸酶与成骨细胞活性相关），且被证明具有临床价值。对结果的详细分析使得能够确定疾病临床活动的阶段，并更准确地检查治疗方法的疗效。
