甲状腺功能亢进患者骨密度与骨代谢指标的临床观察

Bone mineral density and bone metabolism index in hyperthyroid patients

目的观察甲状腺功能亢进患者骨密度（BMD）与骨代谢指标的改变。方法应用双能X线测定仪（DXA）检测86例甲状腺功能亢进患者BMD和髋关节强度指数（FSI），同时测定血清骨钙素（BGP）、总Ⅰ型前胶原氨基端延长肽（PINP）和B-胶原降解产物（B-Crosslaps）。结果甲状腺功能亢进患者并发骨质疏松发生率20．9％，并发骨量减少占40．7％，与对照组比较，甲状腺功能亢进忠者BMD和FSI明显低于对照组（P〈0．05），骨代谢指标BGP、PINP和B-Crosslaps明显升高（P〈0．05，P〈0．01）。结论甲状腺功能亢进时反映成骨细胞活性的BGP和PINP和反映破骨细胞活性的8-CrossLaps均明显升高，且以破骨指标升高明显，呈高转换型骨质疏松。

Objective To observe the changes of bone mineral density and bone metabolism index in hyperthyroid patients. Methods Bone mineral density （ BMD ） was measured dual with energy X-ray absorption metry and serum ostecocalcin （ BGP ） , procollagen type I amino-terminal propeptide （ PINP ） , and β -Crosslaps levels were measured in 86 patients with hyperthyroidism.Results The osteoporosis rate was 20.9% and the osteopenia rate was 40.7% in the patients with hyperthyroidism. BMD and FSI were significantly lower （P 〈 0.05 ） and the values of bone metabolic bioehemieal markers were significantly higher （P 〈 0.05, P 〈 0.01 ） in patients with hyperthyroidism than in the control group. Conclusions BGP and PINP indicating the activities of osteoblasts and 13-Crosslaps indicating the activities of osteoclasts increase in patients with hyperthyroidism, expecially -Crosslaps, which displays high turnover osteoporosis.