Ⅱ型碳酸酐酶、活化T细胞核因子与老年男性骨质疏松症中医证型关系的探讨

发布时间：2018-01-03 07:14

本文关键词：Ⅱ型碳酸酐酶、活化T细胞核因子与老年男性骨质疏松症中医证型关系的探讨　出处：《福建中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本研究通过分析老年男性骨质疏松患者骨密度、骨代谢指标、ⅡI型碳酸酐酶(CAⅡ)、活化T细胞核因子(NFAT2)等指标,研究老年男性骨质疏松症不同中医证型与上述指标是否存在关联,为老年男性原发性骨质疏松辨证分型诊断提供帮助。方法：根据病例纳入、排除标准,从2015年03月至2015年09月在厦门大学附属中山医院老年科、康复科门诊及病房就诊的老年男性患者,检测患者Ⅱ型碳酸酐酶(CAⅡ)、活化T细胞核因子(NFAT2)、β胶原特殊序列(β-crosslaps)、I型前胶原氨基端延长肽(P1NP)和股骨颈骨密度、腰椎L2-L4骨密度等指标,并与不同中医证型进行相关性分析,所录入的数据采用SPSS21.0统计学软件处理。结果：1、老年男性骨质疏松患者股骨颈骨密度显著低于非骨质疏松患者(P0.01),其各中医证型间均无差异(P0.05)2、肾阳虚型老年骨质疏松患者L2-L4腰椎骨密度低于非骨质疏松患者,但高于肾阴虚组及气滞血瘀组(P均0.05)；气滞血瘀组与肾阴虚组比较无差异(P=0.614)3、气滞血瘀组β-crosslaps值明显高于其他各组(肾阳虚组、肾阴虚组)(P均0.01)4、气滞血瘀组P1NP较其他证型高,肾阳虚与肾阴虚组无差别(P=0.868)5、老年男性骨质疏松症中医证型与血清CAII、NFAT2mRNA表达水平具有相关性：①气滞血瘀组血清CAIImRNA表达水平高于肾阳虚组、肾阴虚组(P0.01)②肾阴虚组血清NFAT2mRNA表达水平高于气滞血瘀组、肾阳虚组,且各组间比较具有显著差异(P0.01)结论：1、各组骨密度结果与β-crosslaps呈反比,与P1NP结果呈正比,符合目前国内外研究2、气滞血瘀组CAIImRNA水平较高,股骨颈骨密度低于其他各骨质疏松组,代表了破骨细胞较高的骨吸收能力,容易引发股骨颈骨折,体现了“因虚致瘀”的中医观点3、骨质疏松患者NFAT2mRNA表达显著升高,提示骨质疏松患者破骨细胞分化形成过程相对活跃。其中肾阴虚组NFAT2mRNA表达量最高,可作为其区别其他证型的参考指标之一。
[Abstract]:Objective: through the analysis of bone mineral density in elderly male patients with osteoporosis, bone metabolism, carbonic anhydrase II type I (CA II), the activation of nuclear factor T (NFAT2) and other indicators of different syndromes in elderly male patients with osteoporosis and the indicators of whether there is an association, for the elderly male patients with primary osteoporosis syndrome diagnostic help. Methods: according to inclusion and exclusion criteria, from the affiliated Zhongshan Hospital of geriatrics at the Xiamen University from 2015 03 to 2015 09 months, the elderly male patients with rehabilitation outpatient and ward treatment, detection of carbonic anhydrase in patients with type II (CA II), activation of nuclear factor T (NFAT2), beta collagen (special sequence beta -crosslaps), procollagen type I amino terminal peptide (P1NP) and bone mineral density of femoral neck, lumbar L2-L4 bone density index, and correlation analysis with different TCM syndromes, the input data by SPSS21.0 statistics Software. Results: 1 elderly male osteoporosis patients with femoral neck BMD was significantly lower than that in patients with osteoporosis (P0.01), there were no differences between the TCM syndrome type 2 (P0.05), kidney yang deficiency type senile osteoporosis patients with L2-L4 bone mineral density is lower than the non osteoporosis patients, but higher than kidney Yin deficiency group and qi stagnation blood stasis group (P 0.05); Qi stagnation and blood stasis group and kidney yin deficiency group had no difference (P=0.614 3), blood stasis group -crosslaps beta value was significantly higher than other groups (kidney yang deficiency group, kidney yin deficiency group) (P 0.01) 4, qi stagnation and blood stasis group P1NP than the other syndromes, kidney yang deficiency and kidney yin deficiency there was no difference (P=0.868 5), the syndrome and serum CAII in elderly male osteoporosis, with the correlation between the expression level of NFAT2mRNA: the expression of qi stagnation and blood stasis had higher serum CAIImRNA level in kidney yang deficiency group, kidney yin deficiency group (P0.01), kidney yin deficiency group serum NFAT2mRNA expression level is higher than that of gas Stagnation of blood stasis group, kidney yang deficiency group, and the comparison between groups had significant difference (P0.01) conclusion: the 1 groups, the results of bone mineral density and beta was inversely proportional to -crosslaps, and is proportional to the P1NP results, in line with the current domestic and foreign research 2, qi stagnation and blood stasis group CAIImRNA level is higher, femoral neck BMD is lower than other osteoporosis group. On behalf of the osteoclast high ability of bone resorption, easily lead to femoral neck fracture, embodies the "because of the viewpoint of Chinese medicine Qi Deficiency" 3, the expression of NFAT2mRNA was significantly increased in patients with osteoporosis and osteoporosis patients with the differentiation of osteoclast formation process is relatively active. The expression of NFAT2mRNA was highest in kidney yin deficiency group, can be used as one of the the difference between the reference index of other syndromes.

【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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