甲状腺激素及骨代谢相关细胞生长因子水平对甲状腺功能亢进症患者的影响

The effect of thyroid hormone and bone metablism-associated growth factor on the patients of hyperthyreosis

目的了解甲状腺素激素及部分骨代谢相关细胞因子水平的改变对甲状腺功能亢进症（甲亢）患者骨代谢的影响。方法采用放免法及化学发光法测定正常人和甲亢患者的血清游离甲状腺素（FT4）、游离三碘甲腺原氨酸（FT3）、促甲状腺素（TSH）、胰岛素样生长因子Ⅱ（IGF-Ⅱ）、降钙素（CT）、白细胞介素6（IL-6）和肿瘤坏死因子（TNV）的水平。结果甲亢患者与正常对照组比较，FT4、FT3和IL-6水平明显增高（t值分别为16．69、11．33、7．92，P〈0．01），而TSH、IGF-Ⅱ、CT、TNF水平均明显降低（t值分别为13．08、8．34、5．29、8．75、P〈0．01）。结论甲亢时高浓度的甲状腺激素可导致IL-6产生过多，CT及IGF-Ⅱ的消耗储存减少，从而引起骨吸收及骨转换增加，钙、磷代谢紊乱，是造成骨丢失诱发骨质疏松的主要原因。

Objective To evaluate the effect of high concentration of thyroid hormone and cell growth factor content on the bone metabolism of hyperthyreosis. Methods Radiation immunological test and chemiluminescence methods are employed to determinate the content of free triiodothyronine （FT3） , free thyroxine （FT4）, thyroid stimulating hormone （TSH）, insulin-like growth factor Ⅱ（ IGF- Ⅱ）, calcitonic （CT）, interleukin-6 （IL-6） and tumor necrosis factor（TNF） of serum in health adult and parts of hyperthyreosis patients. Results Hyperthyreosis patients have a higher content of FT4, FT3 and IL-6 than those of health adult （t was 16.69, 11.33,7.92, respectively, P〈0.01）, while the content of TSH, IGF- Ⅱ, CT, TNF are obvious decreasing （t was 13.08, 8.34, 5.29, 8.75, respectively, P〈0.01）. Conclusion In patients with hyperthyreosis, high concentration thyroid hormone cause accentuation of protein metabolism, decrease calcium homeostasis by disorders of phosphorus and calcium metabolism, high concentration thyroid hormone and low level CT resulted in bone loss. Decreased IGF- Ⅱ may be the main cause of osteoporosis as the result of high concentration thyroid hormone.