骨化三醇对绝经后骨量减少或骨质疏松症患者甲状旁腺素和骨转换指标及尿钙变化的影响

Effects of Calcitriol on the Changes of Parathyroid Hormone, Bone Turnover Markers and Urinary Calcium in Postmenopausal Women with Osteopenia or Osteoporosis

目的观察骨化三醇对绝经后骨量减少或骨质疏松症患者的甲状旁腺素(PTH)、骨转换指标及尿钙的影响。方法入选45例绝经后骨量减少或骨质疏松症患者,以盖三醇(青岛正大海尔制药有限公司)0.5μg/d治疗3个月,于基线和研究结束时检测血尿常规、血钙、血磷、肝肾功能、PTH、血清25-羟基维生素D [25 (OH) D]、骨转换指标及24 h尿钙的变化。结果纳入统计的受试者为36例女性,平均年龄(65.2±5.2)岁。治疗3个月后,血清PTH水平、血清骨钙素(BGP)和I型胶原β-C末端肽交联(β-CTX)水平下降,差异有统计学意义。1例患者发生轻度高血钙。基线时24 h尿钙为(4.20±1.60)mmol,治疗3个月后上升为(6.33±2.28)mmol,差异有统计学意义。结论骨化三醇在治疗绝经后骨质疏松症的过程中,能降低血PTH水平,偶有轻度高血钙发生,使用后24 h尿钙有所增加。

Objective To observe the effects of calcitriol on the parathyroid hormone(PTH), bone turnover and urinary calcium in postmenopausal women with osteopenia or osteoporosis. Methods 45 patients with osteopenia or osteoporosis after menopause were treated with calcitriol(0.5μg/d) for three months. At the baseline and the end of the study, routine urine and blood test, liver and kidney function, the level of serum parathyroid hormone and 25(OH) D, bone turnover markers and24-hour urine calcium of the subjects were detected. Results At the end of the three-month study, 36 subjects finished this study with an average age of(65.2±5.2) years. Their serum levels of PTH, BGP and-CTX decreased significantly after 3 months;one case suffered from mild hypercalcemia. The baseline 24-hour urinary calcium level were(4.20±1.60) mmol, and it increased to(6.33±2.28) mmol after 3 months of treatment, the difference was statistically significant. Conclusion During the treatment of postmenopausal osteoporosis, calcitriol can reduce the level of serum PTH, increase 24-hour urinary calcium level,but induce mild hypercalcemia occasionally.