骨化三醇对男性酒精性肝硬化患者骨密度和骨代谢的影响

Effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis

目的:探讨补充骨化三醇对酒精性肝硬化患者骨密度和骨代谢指标的影响。方法:将维生素D缺乏的酒精性肝硬化患者随机分成观察组和对照组,两组常规治疗相同,观察组给予骨化三醇胶丸(0.25μg/d)治疗,比较两组治疗半年后骨密度及β胶原特殊序列(β-CTx)、25-羟维生素D(25-OHD)、血钙、血磷、甲状旁腺激素(PTH)等骨代谢指标的差别。结果:观察组治疗后血磷、PTH均较治疗前显著下降,25-OHD、血钙均较治疗前显著上升,差异均有统计学意义(P<0.05);对照组治疗后25-OHD较治疗前显著下降,差异有统计学意义(P<0.05);治疗后,观察组血钙和25-OHD显著高于对照组,血磷和PTH显著低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组和对照组骨密度、T值、β-CTx和肝功能比较,差异无统计学意义(P>0.05)。结论:补充骨化三醇半年可改善酒精性肝硬化患者维生素缺乏状态,但未发现能阻止骨破坏和提高骨密度。

AIM： To explore the effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cir- rhosis. METHODS： 112 male patients with alcoholic cirrhosis were randomly divided into the observe group（n=56）and the control group（n= 56）. They all accepted the conventional treatment, but the patients in the observed group were given the treatment of caleitriol （0.25 V g/ d）. The difference of the bone mineral density, beta-isomerized C-telopeptide （β-CTx）, 25- hy- droxy vitamin D （25-OHD）, serum calcium, serum phosphorus and parathyroid hormone （PTH） were compared between the two group after 6 months treatment. RESULTS： The serum phosphorus and PTH in the observed group after treatment were significantly lower than that be- fore treatment（P〈0.05）, and the 25-OHD and serum calcium in the observed group after treat- ment were significantly higher than that before treatment（P〈0.05） ; the 25-OHD in the controlgroup after treatment were significantly lower than that before treatment （P 〈 0.05）. After treatment, the serum calcium and the 25-OHD in the observation group were significantly higher than that in the control group（P〈0.05）, the serum phosphorus and PTH in the observation group were significantly lower than that in the control group（P〈0.05）. After treatment, there is no significant difference of bone mineral density, T score, β-CTx and liver function both in the observation group and in the control group （P〉0.05）. CONCLUSION： Supplement of vitamin D for 6 months could improve vitamin deficiency in male patients with alcoholic cirrhosis, but can＇t stop the destruction of bone and increase bone mineral density.