摘要
目的研究甲状腺功能亢进症病人的钙磷代谢、骨转换和骨密度改变。方法应用双能Ｘ线吸收法测量３８例甲状腺功能亢进症患者的骨密度，并与年龄和性别相匹配的健康志愿者（对照组）相比较。结果甲状腺功能亢进症患者的血游离钙水平（１．２２±０．０９ｍｍｏｌ／Ｌ）与２４小时尿钙排量（６．５±２．５ｍｍｏｌ／２４ｈ）显著高于健康对照组（１．１８±０．０５ｍｍｏｌ／Ｌ和３．１±１．２ｍｍｏｌ／２４ｈ，Ｐ值均＜０．００１）。血磷水平（１．１±０．２ｍｍｏｌ／Ｌ）和２４小时尿磷排量（２１．７±６．５ｍｍｏｌ／２４ｈ）较对照组增高（１．０±０．２ｍｍｏｌ／Ｌ和１８．０±４．０ｍｍｏｌ／２４ｈ，Ｐ值均＜０．０５）。血抗酒石酸酸性磷酸酶和２４小时尿羟脯氨酸（ＨＹＰ）排量高于对照组（Ｐ值均＜０．００１），血骨钙素（ＢＧＰ）和碱性磷酸酶（ＡＬＰ）也较对照组升高（Ｐ值均＜０．００１）。尿ＨＹＰ排量和血ＢＧＰ均与血游离三碘甲状腺原氨酸呈正相关（ｒ＝０．３８，Ｐ＜０．０５；ｒ＝０．３３，Ｐ＜０．０５）。骨密度测定显示全组骨量丢失在前臂远端１／１０部位为５８％（２２例），１／３部位为８２％（３１例），腰椎２～４为１６％（６例），股骨颈３５％（１３例），?
Objective To investigate the changes of bone, mineral metabolism and bone mineral density (BMD) in 38 hyperthyroidism patients before treatment. Methods BMD was measured using DXA, the sex and age were matched with the normals of the control group. Results The levels of plasma ionized calcium and serum phosphorus were elevated ( P <0.001, P <0.05) with increased urinary excretion of calcium and phosphorus as compared with the controls ( P <0.001, P <0.05), indicating a negative calcium and phosphorus balance in hyperthyroidism patients. The serum levels of bone GLA protein (BGP), alkaline phosphotase, tartrate resistant acid phosphotase, and the urinary excretion of hydroxyproline were also elevated. The BMD measurements revealed that, in the forearm the frequencies of bone mass loss were 82% for the distal one third portion and 58% for the distal one tenth portion, and in the lumbar vertebrae and hip the frequencies were 16% for lumbar 2～4, 35% for femoral neck, 55% for Wards triangle and 35% for trochanter. Conclusion There were the negative calcium and phosphorus balance and higher bone turnover, bone mass loss occurred earlier in cortical bone than in trabecular bone in 38 patients with hyperthyoidism.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第3期175-178,共4页
Chinese Journal of Internal Medicine
基金
国家自然科学基金
中国医学科学院科研基金
关键词
甲状腺机能亢进
钙
磷
骨代谢
Hyperthyroidism Bone density Calcium metabolism Phosphorus metabolism
