[1]沈博,周鑫,吴楠,等.强直性脊柱炎早期诊断与疾病进展评估的关键骨转换标志物的筛选与应用[J].陕西医学杂志,2026,(7):925-929.[doi:DOI:10.3969/j.issn.1000-7377.2026.07.009]
　SHEN Bo,ZHOU Xin,WU Nan,et al.Screening and application of key bone turnover markers for early diagnosis and disease progression assessment of ankylosing spondylitis[J].,2026,(7):925-929.[doi:DOI:10.3969/j.issn.1000-7377.2026.07.009]
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强直性脊柱炎早期诊断与疾病进展评估的关键骨转换标志物的筛选与应用

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年7期
页码:
925-929
栏目:
临床研究
出版日期:
2026-07-05

文章信息/Info

Title:
Screening and application of key bone turnover markers for early diagnosis and disease progression assessment of ankylosing spondylitis
作者:
沈博1; 周鑫2; 吴楠3; 范昭鹏3; 曹慧玲2; 郭华1; 3
（1.陕西中医药大学第二临床医学院，陕西 咸阳 712046；2.西安医学院药学院，陕西 西安 710021；3.西安市第五医院骨科，陕西 西安 710082）
Author(s):
SHEN Bo1; ZHOU Xin2; WU Nan3; FAN Zhaopeng3; CAO Huiling2; GUO Hua1; 3
（1.Second Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang 712046,China;2.Xi ’an Medical University,Xi’an 710021,China;3.Orthopedics department,Xi’an No.5 Hospital,Xi’an 710082,China）
关键词:
强直性脊柱炎; 骨转换标志物; β胶原特殊序列; 早期诊断; 疾病进展; 骨量减少
Keywords:
Ankylosing spondylitis; Bone turnover markers; β collagen specific sequence; Early diagnosis; Progression of disease; Bone loss
分类号:
R 681.5
DOI:
DOI:10.3969/j.issn.1000-7377.2026.07.009
文献标志码:
A
摘要:
目的：本研究探究通过检测正常人与强直性脊柱炎（AS）患者血清标志物，筛选发现可用于AS早期诊断的骨转换标志物(BTMs)，随后通过检测早期、进展期、稳定期AS患者血清标志物，筛选发现可用于AS进展评估的BTMs。方法：收集正常人血清45例，AS患者血清44例(早期21例，进展期15例，稳定期8例)，检测BTMs，如血清I型前胶原氨基端前肽(PINP)、骨钙蛋白(BGP)、β胶原特殊序列(β-CTX)，C-反应蛋白(CRP)、红细胞沉降率(ESR)。采用双能X线吸收测定法检测受试者左前臂骨密度值(BMD T)。绘制受试者工作曲线(ROC)分析血清PINP、BGP、β-CTX、CRP、ESR对AS患者骨量减少的预测价值。结果：①与正常人比较，AS患者血清的β-CTX、β-CTX/PINP、ESR与CRP显著升高，BGP与BMD T值显著降低。ROC曲线分析显示，β-CTX 预测骨量减少的效能最高（AUC=0.763），显著优于PINP（AUC=0.286）及其他炎症指标。②随着AS病情进展，β-CTX 水平持续升高，在稳定期达到峰值，其改变早于BMD T值，且与BMD T值呈极强负相关。β-CTX/PINP进展期最高，稳定期最低。结论：β-CTX与β-CTX/PINP可作为AS早期诊断与疾病进展的关键骨转换标志物，同时也是反映AS患者骨量流失程度的核心标志物，适合作为临床AS慢病管理的监测指标。
Abstract:
Objective:This study aims to explore the detection of serum markers in normal individuals and patients with ankylosing spondylitis (AS) to screen for bone turnover markers (BTMs) that can be used for the early diagnosis of AS.Subsequently,by testing the serum markers of patients with early-stage,progressive-stage,and stable-stage AS,BTMs that can be used for the assessment of AS progression will be screened out.Methods：45 cases of normal people’s serum and 44 cases of AS patients’ serum (21 cases in the early stage,15 cases in the progressive stage,and 8 cases in the stable stage) were collected.BTMs were detected,such as serum type I procollagen amino-terminal propeptide (PINP),osteocalcin (BGP),β-collagen specific sequence (β-CTX),and inflammatory indicators,such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).The bone mineral density value (BMD T) of the left forearm of the subjects was measured by dual-energy X-ray absorptiometry.The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum PINP,BGP,β-CTX,CRP,and ESR for bone loss in AS patients.Results:①Compared with normal individuals,the serum levels of β-CTX,β-CTX/PINP,ESR and CRP in AS patients were significantly elevated,while BGP and BMD T values were significantly decreased.ROC curve analysis showed that β-CTX had the highest efficacy in predicting bone loss (AUC=0.763),which was significantly better than PINP (AUC=0.286) and other inflammatory indicators.② As the AS disease progressed,the level of β-CTX continued to increase,reaching its peak in the stable phase.Its change occurred earlier than BMD T values,and it was strongly negatively correlated with BMD T values.β-CTX/PINP was the highest in the progressive stage and the lowest in the stable stage.Conclusion:β-CTX and β-CTX/PINP can serve as key markers of bone turnover for the early diagnosis and disease progression of AS,and they are also core indicators reflecting the degree of bone loss in AS patients.They are suitable as monitoring indicators for the chronic disease management of AS in clinical practice.

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备注/Memo

备注/Memo:
国家自然科学基金资助青年基金项目(82200513); 陕西省中医药管理局项目(TZKN-CXPT-04)
更新日期/Last Update: 2026-07-10