正常妊娠钙代谢和骨吸收指标的变化

Changes of calcium metabolism markers and bone mineral density in normal pregnancy

目的 :探讨正常妊娠期及产后恢复期钙代谢指标和骨密度的变化。方法 :对 43例正常妊娠期及产后恢复期和 2 1例健康妇女对照组分别测定骨密度、抗酒石酸酸性磷酸酶、血清白蛋白、总钙、离子钙、碳酸氢根、尿Ca/Cr比值。结果 :妊娠期及产后期骨密度无明显变化 ,血清白蛋白自妊娠 30d后逐渐明显降低 ,总钙降低 ,离子钙无变化 ,抗酒石酸酸性磷酸酶增高 ,尿Ca/Cr比值升高 ,妊娠中期后碳酸氢根下降。各项变化指标产后 2个月后逐步恢复正常。正常妊娠期总钙 ,尿Ca/Cr比值 ,抗酒石酸酸性磷酸酶的参考值分别为 :2 17± 0 2 3mmol/L ;0 6 1± 2 4 ;5 9± 1 9u/L。结论 :妊娠期间骨吸收指标无明显改变 ,血清离子钙增高 ,骨代谢明显活跃。

Objective To explore the changes in bone mineral density and calcium metabolism markers during pregnancy and puerperium.Method Bone mineral density and plasma activity of tartrate-resistant acid phosphatase and serum concentrations of albumin,total calcium,ionized calcium,bicarbonate and urinary Ca/Cr ratio were measured in 43 normal pregnancy and postpartum women and 21 women for control.Results No significant differences in bone mineral density was found during pregnancy and puerperium.The albumin gradual lygnificant decreased after 30 days pregnancy.The total calcium concentration decreased and ionized calcium were unchanged.The tartrate-resistant acid phosphatase increased.Urinary Ca/Cr ratio tended to rise through pregnancy to term.The bicarbonate decreased from second trimester.All markers gradual recovery to normal by two months postpartum.It is normal in pregnancy that T-Ca,urinary Ca/Cr and TrACP were 2.17±0.23mmol/L;0.61±2.4;5.9±1.9u/L respectively.Conclusion Pregnancy had not a significant effect on marker of bone resorption.The ionized calcium concentration increased.The bone metabolism was active.