甲状腺机能亢进患者骨代谢指标的变化

Changes of bone metabolism in hyperthyroid patients

目的 观察甲状腺机能亢进 (甲亢 )患者骨代谢指标的变化。方法 对 83例甲亢患者进行如下项目测定 :( 1)血钙 (Ca)、血磷 (P)、碱性磷酸酶 (AKP)、骨钙素 (BGP)、抗酒石酸酸性磷酸酶(TRAP) ;( 2 ) 2 4h尿Ca、P、羟脯氨酸 (HOP) ;( 3)尿Ⅰ型胶原氨基末端肽 (NTX) /Cr;( 4 )骨密度 (BMD)、胫骨骨超声 (SOS)。结果 甲亢患者的Ca、P、AKP、胫骨SOS与正常对照组没有显著差别 ;甲亢组的BGP、TRAP和 2 4h尿Ca、P、HOP、NTX/Cr、BMD与正常对照组没有显著差别 ;BGP与T3、FT3 有很好的相关性 (r=0 .38、0 .40 ,P <0 .0 1) ;NTX 与T3、T4 、FT3、FT4 有相关性 (r =0 .35、0 .4、0 .31、0 .45 ,P <0 .0 1)。结论 甲亢患者的骨吸收大于骨形成 ,BGP和NTX 不仅是观察甲亢患者骨代谢的重要指标 。

Objective To investigate the change of bone metabolism in patients with hyperthyroidism.Methods BMD,serum Ca,P,AKP,BGP,TRAP and urine Ca/Cr were measured in 83 hyperthyroid patients and 50 healthy subjects.Results BMD,serum BGP,TRAP and urine NT X,Ca/Cr,24 hr Ca,P,HOP in hyperthyroid patients were significantly higher than those in the healthy subjects(P<0.05 or P<0.01),BGP was negatively correlated with T 3,FT 3(r=0.38,0.40,P<0.01);NT X was correlated with T 3,T 4,FT 3,FT 4(r=0.35?0.4?0.31?0.45,P<0.01).Conclusion High turnover type osteoporosis exists in hyperthyroidism and BGP and NT X are not only the sensitive indices reflecting bone formation and absorption but also the indices reflecting therapeutic effect in hyperthyroid patients.