A Study Of The Change Of Bone Mineral Density And Bone Metablism After A Subtotal Gastrectomy

Object:The aim of our study is researching for the changes in bone mineral density and bone metabolism biochemical indicators in patients after the subto-tal gastrectomy, and relationship with the changes between bone mineral den-sity and bone m-etabolism biochemical indicators in order to achieve the purp-ose of the diagnosis of the bone disease after gastrectomy and for clinical p roviding the theory basis for early intervening the changes of human body aft-er gastrectomy.we selected the people living in jingzhou for most5years of37cases o f patients after gastrectomy for peptic ulcer line for the test group.Exclusion c-riteria:thyroid disease、diabetes mellitus、parathyroid disease;Serious liver an d gall disease; premary or secondary bone tumors; serious problems of the bl-ood system,such as multiple myeloma, lymphoma,et. the seriou-s kidney disea se history; No long-term used of known to affect bone metabolism drugs such as:steroids, diuretic drugs history of drug; The long-term bed; Without fract-ure history; Refuse to check the and testing. Patients age was between25-78years, the postoperativetime is between in5to20years,21cases of men a-nd16cases women in the people.we selected86of the petic ulcer patientin digestive department in the first people’s hospital of jingzhou as ulcer diseas-e control group. Exclusion criteria:thyroid disease、diabetes melli-tus、parath-yroid disease; Serious liver and gall disease; premary or secondary bone tumo rs; serious problems of the blood system,such as multiple myeloma, lympho-ma,et,al. the serious kidney disease history; No long-term use of known to aff-ect bone metabolism drugs such as:steroids, diuretic drugs history of drug; The long-term bed; Without fracture history; Refused to check the and testin-g. we selected96of the healthy crowd in medical branch in the fir-st people’ s hospital of jingzhou during March2011to november2011as ulcer disease control group,the male55cases,women41cases. no peptic ulcers, fracture, en-docrine system disease history and not taking known to affect the bone m-etabolism drugs.Among the three goups the age、weight and gender ratio have-n’t diffrence.Bone mineral density of middle phalanges of index finger、middl e finger ring finger of non-dominant hand were tested by MetreiScanTM bon-e mineral density measure apparatus,taking the average.the level of serum oste ocalcin, serum PICP and serum metal matrix protease-13were tested by Enzy me-linked immunosorbent adsorption experiment(ELISE).All data were express ed as means±sem,using LSD-test to analyze the data,Pearson cor-relatio-n was used in correlation analysis.Using LSD-test to analyzethe relation of bone mineral density among th-ree groups, the result shows bone mineral density in test group significantly lower than ulcer patient group a-nd the normaol control group (p<0.05), The difference of bone mineral density between ulcer patient group and the nor-mal control group wasn’t statistically signifucient.(p>0.05). Serum osteocalcin comparison:the level of osteocalcin in test group was significantly lower than in theulcer patient group and normal control group (P<0.05), The differen-ce of the level of serum osteocalcin between ulcer patient group and the nor mal control group wasn’t statistically significant.(p>0.05). the analysis results o n the correlation between Osteocalcin and bone mineral density showed that the osteocalcin level was a positive correlation with finger bone mineral dens-ity. The changes of serum PICP among three groups s-howed that the differec e of the level of serum PICP between in test group a-nd those of ulcer patie nt group and the normal control grou-p had statisticallysignifficant(p<0.05), t he level of serum PICP in test group was lower than those in the ulcer pati ent group and normal control group. But the differeceof the levelof PICP bet ween in the ulcer patient group and normal control group had notstatisticall y signifficant(p>0.05). The correlation analysis betweenPICP and bone mineral density showed that the level of serum PICP was a positive correlation wit h finger bone mineral density (P<0.01).comprasion of the level of matrix m etalloproteinases-13among three groups:the LSD-test was used to analyze the result between every two groups,and the results of two ana-lysis:the differe nce among the test group,the ulcer patient group, the normal c-ontrol group w as not statistically significant (P>0.05);the differece between the test group and the normal control group、the testl group and the ulcer patient disease、t-he normal control group and the ulcer patient were no statistica-lly significant (P>0.05).Conclusion:1. the finger bone mineral density in patients after gastrecto-my significantly lower than the peptic ulcer disease patients and the normal adult, the differece of bone mineral density between the peptic ulcer patiens and normal adult was not significant. The level of serum osteocalcin, serum P ICP inpatiets after gastrectomy was significantly lower than peptic ulcer dis-ease patiets and normal adult, but those of people between in normal adults and peptic ulcer were no significant differences.The serum osteocalcin level a-nd bone mineral density、serum PICP level and bone mineral density were p-ositively correlated.Using the method to measure bone mineral density is con-v enient.,combined with the determination of serum osteocalcin and serum PICP may be early effectivly able to diagnose bone disease after resection, an effe ctive method of bone disease.