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失代偿性髋关节炎和膝关节炎中钙、磷、羟脯氨酸及氮的研究

The study of calcium, phosphorus, hydroxyproline, and nitrogen in decompensated coxarthroses and gonarthroses.

作者信息

Stĕpán J

出版信息

Z Rheumatol. 1976 Sep-Oct;35(9-10):363-76.

PMID:983358
Abstract

A study was undertaken to find our the biological profile of bone symptomatology of decompensated coxarthrosis and gonarthrosis. In a group of 77 patients and in 48 individual patients the levels of calcium, phosphorus, hydroxyproline and nitrogen were studied for four successive days. Calcium was administered by the intravenous route on the third day (186 mg). The results were compared to 16 healthy controls. Analysis was made with reference to the differences in sex, age, stature and anabolic therapy. The products eliminated were referred in absolute amounts to the body surface and to the period of 1 minute. 91 patients and 17 healthy controls were subjected to a provoked hypercalciuria test. Five patients were followed up in a 47Ca kinetic study and its result was compared to the content of Ca/P and P/Ca in serum and urine found in the same patients and in 21 healthy controls. The biological profile was also compared to a group of patients with gonarthrosis and varose deformity and to 127 patients with inflammatory joint diseases. From the results it is assumed that in women with decompensated coxarthrosis and gonarthrosis the syndrome of disease is a bone manifestation which affects the mineral bone substrate and particularly its calcium level. Phosphorus and the organic products of bone (nitrogen and hydroxyproline) of these patients are susceptible to intravenous administration of calcium. In women the metabolism of collagen appears to be more active than that seen in controls, and tends to resemble that of phosphorus. With its lower activity calcium tends to relate to noncollagenic products, such as osseomucoid (glycoprotein, proteoglycan) and osseoalbumoid. In accord with the findings, the patients show a higher miscible pool of calcium (47Ca), and its lower elimination (in urine and stools) and lower accretion to bone. There are a number of factors (sex, stature, age, clinical compensation of disease) that must be taken into consideration when evaluating the results.

摘要

开展了一项研究以查明失代偿性髋关节炎和膝关节炎骨症状的生物学特征。在一组77例患者以及48例个体患者中,连续四天研究了钙、磷、羟脯氨酸和氮的水平。在第三天通过静脉途径给予钙(186毫克)。将结果与16名健康对照者进行比较。参照性别、年龄、身高和合成代谢疗法的差异进行分析。所排出的产物以绝对量表示为体表面积和1分钟的时间段。91例患者和17名健康对照者接受了激发性高钙尿试验。5例患者进行了47Ca动力学研究,并将其结果与同一患者以及21名健康对照者血清和尿液中Ca/P和P/Ca的含量进行比较。还将该生物学特征与一组患有膝关节炎和静脉曲张畸形的患者以及127例炎性关节疾病患者进行了比较。从结果推测,在患有失代偿性髋关节炎和膝关节炎的女性中,疾病综合征是一种影响骨矿物质基质尤其是其钙水平的骨表现。这些患者的磷和骨的有机产物(氮和羟脯氨酸)对静脉注射钙敏感。在女性中,胶原蛋白的代谢似乎比对照组更活跃,并且倾向于类似于磷的代谢。由于其活性较低,钙倾向于与非胶原蛋白产物相关,例如骨黏蛋白(糖蛋白、蛋白聚糖)和骨白蛋白。与这些发现一致,患者表现出较高的钙混合池(47Ca),其排泄(尿液和粪便中)较低且骨沉积较低。在评估结果时必须考虑许多因素(性别、身高、年龄、疾病的临床代偿情况)。

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