甲亢合并骨质疏松患者生长激素变化的研究

Changes of growth Hormone in patients with hyperthyroidism accompanied by osteloporosis.

目的 了解甲亢合并骨质疏松病人血清生长激素水平的变化 ,同时探讨甲状腺激素水平、年龄、病程等相关因素对骨量丢失的影响。方法 选择未经治疗的甲亢病人 1 4 6例为研究对象 ,排除其他疾病、药物、绝经、高龄等影响因素。依骨密度 (BMD)结果分为三组 ,即BMD正常组、骨量减少组、骨质疏松组。以直线相关分析法检验上述各变量间的相关性。结果 GH、ALP与BMD之间有非常显著负相关。GH与年龄、病程、T3 、T4等指标之间无显著相关性。Neck、Ward′s、Troch三部位的BMD与T3 、T4及病程之间呈显著负相关 ,而L2～4的BMD与上述三指标无显著相关性 ,却与年龄呈负相关。结论 甲亢合并骨质疏松病人血清GH水平随着BMD的减少而升高。GH在此可能起到了促进骨形成 ,减少骨量丢失的代偿作用。GH测定可作为甲亢合并骨质疏松患者观察指标之一。此外 ,甲亢病人以股骨上端的BMD减低为主 ,腰椎的BMD受T3 、T4及甲亢病程的影响较小 。

Objective\ To study the changes of growth hormone(GH) in blood serum of patients with hyperthyroidism accompanied by osteoporosis,and to explore the influence of the related factors,such as thyroid hormone level,age,and course of disease on bone loss. Methods\ With influencing factors such as other diseases,drugs,menopause and advanced age excluded,146 newly\|diagnosed contreated patients were recruited.According to the data of BMD,the patiedts were divided into three groups:normal group,osteopenia group and osteoporosis group.Correlatson of the above indexes was analyzed. Results\ There were significant negative correlations between GH,ALP and BMD,no correlations beween GH and age,course of disease,T\-3,T\-4, and there also were negative correlations between the BMD of Neck,Ward's Troch,and T\-3,T\-4 and course of disease,but there were no correlations between the BMD of L 2\|4 and the above three indexes,except its negative correlation with age. Conclusion\ The GH level in the patients with hyperthyroidism accompanied by osteoporosis rises with the reduction of the BMD.GH may play a compensative role in promoting the formation of bone and reducing the bone loss.Meanwhile,GH prove to be one of the manifest indexes to inrestigate the changes in the patients with hyperthyroidism accompanied by osteoporosis.The patients with hyperthyroidism reduction of BMD in upper end of femur,while the BMD of lumbar spines is little influenced by T\-3\,T\-4 and course of hyperthyroidism,but is associated with increase in age.\;