原发性甲状旁腺机能亢进甲状旁腺细胞增生与骨矿密度相关性研究

The relationship between the proliferation of parathyroid cell in rabbit with primary hyperparathyroidism and the bone mineral density

目的探讨原发性甲状旁腺机能亢进（PHPT）中甲状旁腺细胞增生与骨矿含量的关系。方法健康成年中国白兔80只，采用简单随机化分组法分成2组，对照组40只以正常饮食（Ca：P=1．0：0．7）喂养，实验组40只以高磷饮食（Ca：P=1．0：7．0）喂养，诱发原发性甲状旁腺机能亢进动物模型。在第3、4、5、6个月末，分别对实验组和对照组动物行定量CT（QCT）检查，测定其骨矿密度（BMD）。对所有动物甲状旁腺做甲状旁腺细胞计数，同时采用免疫组织化学法测定腺体增殖细胞核抗原（PCNA）和凋亡抑制基因（Bcl）-2的表达情况。对所获数据进行t检验和回归分析。结果腺体细胞计数实验组[（673±151）个／高倍镜视野]是对照组[（418±25）个／高倍镜视野]的1．61倍（P〈0．01）；实验组腺体中PCNA阳性率[（50．52±11．62）‰]比对照组[（26．70±2．78）‰]明显增加（P〈0．01）。实验组腺体Bcl-2表达阳性率[（460．37±190．05）‰]比对照组[（67．02±4．38）％。]明显上调（P〈0．01）。实验组BMD值[（152．5±34．3）g／cm^3]较对照组[（188．6±12．2）g／cm^3]下降（P〈0．05）。实验组BMD值与PCNA、Bcl-2表达呈负相关（r值分别为-0．749、-0．800，P值均〈0．05）。结论PHPT的骨密度与甲状旁腺腺体细胞的增生密切相关，为PHPT的早期诊断和治疗提供可靠的依据。

Objective To evaluate the relationship between the proliferation of parathyroid cell in rabbit with primary hyperparathyroidism （PHPT） and the bone mineral density （BMD）. Methods Eighty adult Chinese rabbits were randomly and equally divided into two groups. The contrast group was fed with normal diet （ Ca ： P, 1.0 ： 0. 7 ） and the experimental group was fed with high phosphate diet （ Ca ： P, 1.0： 7.0） to establish the animal model of PHPT. At 3, 4, 5, and 6 months after the diet, bone mineral density of the rabbits was measured by the quantity CT （ QCT）. Then, the parathyroid and bone of the rabbits were removed for pathological examination. The number of parathyroid cell in PHPT was calculated. Proliferation was determined by immunohistochemistry of proliferation cell nuclear antigen （PCNA） and Bcl- 2. The t test and Logistic regression was used to analyze the difference of data of two groups. Result The number of parathyroid cell in PHPT group was 1.61 times than that in the contrast group[ （673 ＋ 151 ） HP, （418 ± 25 ） HP,P 〈 0.01 ] . The rate of PCNA positive-cell was significantly increased in PHPT group than that in contrast group [（50.52 ± 11.62）‰, （26.70 ±2.78）‰, P 〈 0.01], and so was Bcl-2 [ （460. 37± 190. 05）‰, （67.02 ±4. 38）‰,P 〈0. 05]. The value of BMD was significantly decreased in PHPT group than that in eontrast group [ （ 152. 5 ± 34. 3 ）, （ 188.6± 12. 2） g/cm3, P 〈 0.05 ]. There was a negative correlation between BMD and PCNA （ r = - 0. 749, P 〈 0.05 ） and between BMD and Bel-2 （ r = - 0. 800, P 〈 0. 05 ） in PHPT group. Conclusion The BMD of PHPT is related to the parathyroid cells proliferation which provide a reliable method for early diagnosis of PHPT.