背景:壓力性骨折常見於特殊活動和部位，骨掃描可有效偵測，但對受犯骨骼的生化變化可能無法立即反應，本研究即利用骨標記評估壓力性骨折之骨生化變化。
方法:以65位壓力性骨折病人為研究對象，所有病人均接受兩腳X光檢查及骨掃描診斷為壓力性骨折，並禁止進一步劇烈、運動，同時紀錄徵狀出現至診斷期間。19位性別及年齡相仿正常人為對照組，生化檢查包括血中骨形成，即carboxy1-termina1 propeptide of type I procollagen (PICP)及骨吸收即cross-linked carboxyl-termina1 telopeptide of type I collagen (ICTP)標記。
結果:壓力性骨折以且還骨最為常見，從徵狀發生至診斷平均為5.5天，ICTP在骨折病人明顯高於對照組(7.2± 2.4 vs. 4.0 ± 1.1Ilg/L;P< 0.001) ，其中8位病人在追蹤後至有意義降低(7.9± 1.2vs. 6.7 ± 1.4/L; P< 0.01) ，有趣的是ICTP與徵狀出現至診斷期間主反比關係，PICP則變化不大。
結論:合併ICTP與PICP可以協助瞭解壓力性骨折病人骨重塑狀態。此一變化似可配合影像檢查作為病人病程變化與療效之參考

Background: Stress fractures (SF) are common lesions that occur in specific areas and are related to specific activities. Bone scan serves as a useful modality for the early detection of SF. However， it may not reliably reflect the biochemical dynamics of the involved bone. Several reliable biochemical markers have been developed to reflect the status of bone formation and resorption. These markers can provide information about the rate of bone turnover that is difficult to obtain based on image studies. This study examined the changes of serum bone markers in patients with stress fracture.
Methods: Sixty-five military recruits with SF participated in the study. Roentgenograms of both lower legs， and concomitant bone scans were performed. Training exercises were prohibited for those patients with a diagnosis of SF. The durations from the onset of symptoms to the initial diagnosis of SF was recorded. Ilineteen gender and age-matched military recruits without SF served as controls. Biochemical markers included serum carboxyl-terminal propeptide of type I procollagen (P ICP) for bone formation and cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) for bone resorption.
Results: The tibia was the most frequently injured site. The duration from onset of symptoms until diagnosis averaged 5.5 days. Bone scans showed positive findings earlier than roentgenograms. The mean serum ICTP level in patients with SF was significantly increased compared with controls (7.2±2.4 vs. 4.0±1.1 g/L; P<0.001). However， the mean PICP values were not significant difference between both groups. Sixteen patients showed a significant decrease of mean ICTP level in follow-up examinations (7.9±1.2 vs. 6.7±1.4 g/L; P<0.01). Interestingly， the changes of serum ICTP concentrations were inversely correlated with the number of days from onset of symptoms until initial diagnoSIS

Conclusion: Interpretation of serum ICTP and PICP values may provide clues regarding the sequence of bone remodeling in patients with stress injury. Patterns of change in these values show promise as a potential complement to the findings of imaging studies which may provide insight into the disease process itself and enable earlier evaluation of the effect of therapy