老年脑卒中患者肢体瘫痪后骨和钙代谢的变化

Changes of bone and calcium metabolism in disabled elderly stroke patients

目的探讨老年脑卒中患者肢体瘫痪对其骨、钙代谢的影响。方法对发病3天以内入院的170例急性期老年脑卒中患者,其中脑梗死患者114例,脑出血患者56例。分别于发病3天内及发病1年后测定血钙(Ca)、碱性磷酸酶(ALP)、骨钙素(BGP)、甲状旁腺激素(PTH)、尿羟脯氨酸(HOP)、尿肌酐(Cr)。结果患者发病3天内血ALP(83.9±25.3)U/L,BGP(9.98±2.91)μg/L,Ca(2.36±0.15)mmol/L,PTH(25.2±14.8)ng/L,尿HOP/Cr(0.64±0.31);1年后患者血ALP(104.20±16.6)U/L,BGP(11.76±1.54)μg/L,Ca(2.48±0.16)mmol/L,PTH(37.0±15.7)ng/L,尿HOP/Cr(0.77±0.42)。发病1年后患者血BGP、ALP,Ca,PTH及尿HOP/Cr比值均明显升高(P均<0.01)。结论老年脑卒中患者肢体瘫痪后骨、钙代谢明显异常。

Objective To study changes of bone and calcium metabolism in disabled elderly stroke patients. Methods The study was conducted on 170 patients with hemiplegia after stroke, who were aged at least 60 years. Blood Ca, alkaline pbosphatase （ALP）, BGP, parathyroid hormore （PTH）, urinary hydroxyproline （HOP） and urinary Cr were measured in 3 days after onset of the disease and after 1 year. Results After 1-year follow-up, the levels of blood ALP, BGP, Ca, PTH and urinary HOP/Cr ratio increased significantly （ P 〈 0.01 0.001）. Conclusion There is significant disturbance of bone and calcium metabolism in disabled elderly stroke patients.