肝硬化患者血清钙、磷、甲状旁腺素及骨密度指标的变化与Child-Pugh分级的关系

Relations between the changes of blood calcium, phosphorus,parathyroid hormone and bone mineral density and Child-Pugh classification among cirrhotic patients

目的探讨肝硬化患者血清钙、磷、甲状旁腺素及骨密度指标的变化与Child-Pugh分级的关系。方法肝硬化患者43例,Child-Pugh分级A级12例,B级16例,C级15例。正常对照组15例,男10例,女5例。用免疫放射法(IRMA)测定甲状旁腺素(PTH),生化检测血清钙(Ca2+)、磷(P3+),单光子骨矿分析仪检测尺骨平均密度。结果血清甲状旁腺素随病情加重显著升高(P<0.01);血清钙、尺骨平均骨密度随病情加重显著降低(P<0.01);Child-Pugh分级A级患者血清甲状旁腺素、钙及骨密度和正常对照组检测结果比较,差异无统计学意义。结论肝硬化患者血清钙、甲状旁腺素及骨密度的变化与肝性骨营养不良之间有密切关系,且与肝硬化程度密切相关。

Objective To investigate the changes of blood calcium, phosphorus, parathyroid hormone (PTH) and bone mineral density(BMD) in liver cirrhotic patients in reference to Child-Pugh classification. Methods Forty-three patients (32 men,11 women; aged 27~72 years old) with liver cirrhosis were divided into 3 groups (class A,B and C) on the basis of Child-Pugh classification, 12 in group A, 16 in group B and 15 in group C. The control group consisted of 15 persons, 10 males and 5 females. The serum levels of PTH were determined by IRMA. Serum levels of calcium, phosphorus were determined, and bone mineral density was measured. Results PTH was increased and calcium and BMD were decreased with the aggravation of the disease(P<0.01). Calcium, phosphorus, PTH and BMD did not show any significant changes in group A and the control group. Conclusions The changes of calcium, PTH in blood and BMD have a close relationship with hepatic osteodystrophy and the degrees of liver cirrhosis.