甲状腺功能亢进症患者治疗前、后血清骨代谢、钙磷代谢水平和甲状腺功能变化及其临床意义

Changes of serum CT,PTH and BGP levels and thyroid function and their clinical significance in patients with hyperthyroidism before and after treatment

目的:探讨甲状腺功能亢进症(甲亢)患者治疗前、后骨代谢、钙磷代谢水平和甲状腺功能变化及其临床意义。方法:回顾性分析85例甲亢患者(观察组)的临床资料,予以常规抗甲状腺药物治疗,选择同时期的40例健康体检者作为对照组。比较观察组患者治疗前、治疗3个月后骨代谢[血清降钙素(CT)、甲状旁腺激素(PTH)、骨钙素(BGP)]、甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、促甲状腺激素(TSH)]、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)和Ca^2+、P^3+等指标的变化,以及与对照组对应指标的差异。结果:治疗前,观察组患者血清CT、BGP、FT3、FT4、TT3、TT4、TPOAb、TGAb、Ca^2+、P^3+水平均高于对照组(P<0.05),治疗3个月后,上述指标均较治疗前降低(P<0.05),与对照组比较差异均无统计学意义(P>0.05);观察组患者治疗前血清PTH、TSH水平均低于对照组(P<0.05),治疗3个月后,上述指标均较治疗前升高(P<0.05),与对照组比较差异均无统计学意义(P>0.05)。结论:甲亢患者经药物治疗后,骨代谢水平、甲状腺功能及钙磷代谢水平均较治疗前明显改善,并可作为疗效和预后评估的重要参数。

Objective:To explore the changes of bone metabolism,thyroid function,calcium-phosphorus metabolism and their clinical significance in patients with hyperthyroidism before and after treatment.Methods:The clinical data of 85 patients(observation group)with hyperthyroidism were retrospectively analyzed.All patients received routine antithyroid drugs.A total of 40 healthy subjects at the same period were selected as a control group.The levels of bone metabolism[serum calcitonin(CT),parathyroid hormone(PTH),bone gla protein(BGP)],thyroid function[free triiodothyronine(FT3),Free thyroxine(FT 4),total triiodothyronine(TT3),total thyroxine(TT4),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),Ca 2+and P 3+were compared before treatment and after 3 months of treatment in observation group,and the differences in the corresponding indexes of control group were compared as well.Results:Before treatment,the serum levels of CT,BGP,FT3,FT4,TT3,TT4,TPOAb,TGAb,Ca 2+and P 3+in the observation group were higher than those in the control group(P<0.05).After 3 months of treatment,the above indexes were increased in the observation group(P<0.05),but no significant difference was found between groups(P>0.05).The serum levels of PTH and TSH in the observation group were lower than those in the control group before treatment,and these indexes were increased after 3 months of treatment in the observation group(P<0.05),while no evident difference was note between the two groups(P>0.05).Conclusion:After drug treatment,the bone metabolism,thyroid function and calcium-phosphorus metabolism were significantly improved in patients with hyperthyroidism,which could be used as important parameters for the assessment of efficacy and prognosis.