甲亢患者骨代谢指标的变化及治疗对其的影响

Markers of Bone Metabolism in Hyperthyroidism and the Effects of Treatment

目的 探讨甲亢两种骨变化指标的临床意义。 方法 选择 2 7例甲亢和 3 0例正常人作为对照 ,分别采用RIA方法和ELISA方法测定血清骨钙素 (OC)和尿吡啶酚 (PYR)含量。 结果 甲亢患者两项指标皆升高 ,与对照组相比 ,OC分别为 (5 4.7± 2 2 .5 )及 (2 3± 7.4) μg/L ,增加 13 9%。PYR分别为 (2 46.3± 181)及 (3 9.5± 11.6)nmol/mmol肌酐 ,增加 5 15 %。大多数患者都高出正常范围 ,且与血清FT3 浓度相关 ,甲亢经治疗后两项指标在一月内回到正常。 结论 PYR是甲亢骨代谢改变的高灵敏指标 ,OC增加幅度低于PYR ,提示骨吸收和骨形成不平衡。

Objective To ascertain clinical significance of two markers of bone turnover in hyperthyroidism. Methods 27 patients were selected as treatment group, and 30 healthy persons as control group. RIA and ELISA methods were used to measure serum osteocalcin(OC) and urinary pyridinoline cross-link(PYR) excretion. Results Hyperthyroid patients had higher (P<0.001) levels of both markers compared with control value.OC levels were 54.7±22.5 mg/L and 23±7.4 mg/L respectively, increased 139%. PYR levels were 246.3±181 nmol/mmol and 39.5±11.6 nmol/mmol creatinine respectively, increased 515%, and were higher than the normal range in most patients,and significantly correlated with serum free FT 3 concentration. Conclusion PYR is a highly sensitive marker for altered bone metabolism in hyperthyroidism. The increase in OC was less impressive.