例畸形性骨炎的临床诊治分析.DOC

8例畸形性骨炎的临床诊治分析 上海交通大学附属第六人民医院骨质疏松和骨病专科 骨代谢病和遗传研究室 鲍春华* 章振林# *鲍春华，进修医生，现在浙江省象山县中医院内分泌科（315730） # 通信作者：章振林 联系电子邮件：ZZL2002@ 电话基金项目：国家自然科学基金81170803）、上海市科委重大科技专题攻关专项（10D1950100）和上海市卫生局新百人优秀学科带头人培养计划（XBR2011014）。 ）Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, P.R. China 【Abstract】 Objective To improve our knowledge of diagnosis and treatment of Paget’s disease of bone, X-ray features, the biochemical marker of bone turnover and the treatment of the Paget’s disease of bone were analyzed. Methods Eight patients with Paget’s disease of bone were diagnosed and introduce the clinical manifestation, X-ray features, change of the biochemical marker of bone turnover and the results of treatment. Results 1. 5 males and 3 females, average aged （60.0±12.2）years (range 46-76 years)。 2. The average course of disease was (5.1±5.0) years(range 1-15 years). 3. It was clinically manifested by the pain, deformity of the bone involved. Two patients were found temperature increase of local surface of bone. 4. Bone lesions of 3 patients were limited in single site, while 4 patients had multiple bone lesions. The commonest sites were pelvis, spine and femurs; the secondly were skull, tibia, fibula, humeral bone, radial bone. 5. X-ray film showed the classic features of Paget`s impaired bone. 6. Bone scan showed increased uptake of 99mTC-Bisphosphonate in involved bone. 7. Serum alkaline phosphatase (ALP) was detected in all patients when they visit before therapy, from 93u/L to 1366u/L(median 326u/L). Only one case had normal serum ALP level. 8. Seven patients were treated by diphosphonates. Diphosphonates reduced the Pagetic bone pain, significantly decreased serum ALP levels, and were effective on Paget’s disease of bone. Conclusion Paget’s disease of bone is very rare in China. The important diagnostic evidence is the remarkable