摘要:目的分析血清骨保护素(osteoprotegerin,OPG)、核因子资B活化因子配体(receptor-activator of nuclear factor kappa B ligand,RANKL)及雌二醇(estradiol,E2)对运动性骨疲劳的早期筛查价值。方法健康雌性大鼠随机分为对照组和实验组,8周训练结束后处死大鼠,采用酶联免疫法检测血清RANKL、OPG和E2水平,采用IBM 21.0 SPSS绘制受试者工作特征曲线曲线(receiver operating characteristic curve,ROC曲线),计算它们的ROC曲线下面积(area under the curve,AUC)、灵敏度和特异度,根据约登指数确定其诊断界值并评价筛查价值。结果血清RANKL、OPG、OPG/RANKL比值及E2的AUC均大于0.9。选定的血清RANKL、OPG、OPG/RANKL比值和E2的诊断界值分别为96.245 ng/ml、2.383 ng/ml、0.028和105.293 pg/ml,其灵敏度和特异度分别为90.21%和45.22%、96.19%和51.07%、94.42%和56.69%、93.36%和40.71%。血清RANKL、OPG、OPG/RANKL比值和E2均早于金标准出现阳性诊断结果。结论动态检测血清RANKL、OPG及E2水平,有望实现运动性骨疲劳的早期预警。
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