甲状腺功能亢进症中血清碱性磷酸酶的测定及其意义

SERUM ALKALINE PHOSPHATASE ACTIVITY IN HYPERTHYROIDISM

本文对64例甲亢患者作了血清AKP测定,结果血清AKP增高(20.3±4.96u%)者26例,占40.6%。13例甲亢患者作了尿羟脯氨酸测定,平均值为51.45mg/24小时尿(24.6~89.6),其中9例超出正常范围。22例AKP增高的患者作了灭活试验,平均AKP值为原来28%,其中9例灭活率低于20%,提示甲亢患者血清AKP升高主要来自骨骼。并讨论了甲亢患者AKP增高的临床意义。

Serum alkaline phosphatase (AKP)activity was studied in 64 cases of hyperthyroidism. The average value was 20.3+4.96 u% ((?)±SD) (K-A unit) in 26 cases (40.6%). The serum total triiodothyronine (TT) level and urinary excretion of phosphate were significantly higher in thyrotoxic patients with increased AKP than those with normal values. There was no difference in serum thyroxin (TT), calcium and phosphate levels, urinary calcium excretion and BMR in the two groups with and without increased serum AKP. The serum levels of calcium, and phosphate were within normal limits in the two groups of patents, but the excretion of calcium was markedly increased in both groups. The urinary excretion of hydroxyproline was determined in 13 patients with a mean of 51.45 mg/24 h (range 24.6-89.6 mg), the excretion rate was elevated in 9 patients. In 22 patients with increased AKP, after the serum was heated to 56℃ for 15 min, the AKP was inactivated to less than 20% of the original value, and in 9 patients, AKP inactivated to less than 20%, suggesting the increased AKP in hyperthyroidism is mainly of osteoblastic origin. The clinical significance of increased AKP in hyperthyroidism is discussed.