维生素D_(2)注射液对维生素D缺乏高龄男性患者血清甲状旁腺激素的影响

Influences of intramuscular injection of vitamin D_(2) on serum parathyroid hormone in very elderly men with vitamin D deficiency

目的研究维生素D_(2)注射液对维生素D缺乏高龄男性患者血清甲状旁腺激素(PTH)的影响。方法将44例维生素D缺乏高龄男性患者随机均分为2组,治疗组在坚持晒太阳的基础上,给予维生素D_(2)注射液60万单位,肌内注射,每月1次,直至血清25-羟基维生素D≥30μg·L^(-1)后停用,而对照组仅坚持晒太阳,与治疗组同步结束观察。检测2组治疗前后血清25-羟基维生素D、PTH、血糖、血钙、血磷、肌酐、丙氨酸转氨酶水平,并记录不良反应发生情况。结果基线时,治疗组和对照组血清25-羟基维生素D、PTH、血糖、血钙等水平均无显著差异(P> 0.05),均完成20例。治疗组血清25-羟基维生素D达标用时(11.9±3.2)个月,取对照组观察第12个月的各项指标进行统计。治疗组治疗后25-羟基维生素D水平显著高于对照组[(31.55±1.95)μg·L^(-1) vs.(12.82±1.93)μg·L^(-1),P <0.01],而PTH水平低于对照组[(37.69±12.68)pg·mL^(-1) vs.(49.38±14.94)pg·mL^(-1),P <0.05]。血糖、血钙、血磷、肌酐、丙氨酸转氨酶水平组间比较差异均无显著意义(P> 0.05),未见严重不良反应发生。结论维生素D_(2)注射液可有效降低维生素D缺乏高龄男性患者的血清PTH水平。

AIM To evaluate the influences of intramuscular injection of vitamin D_(2) on serum parathyroid hormone(PTH) in very elderly men with vitamin D deficiency. METHODS On the basis of receiving adequate sun exposure, a total of 44 men with vitamin D deficiency aged 80 and over were randomized equally into treatment group(vitamin D_(2) 600 000 IU intramuscularly administered every month until the serum 25-hydroxyvitamin D concentration reached 30 μg·L^(-1)) or control group(the observation finished synchronously with the treatment group). The serum 25-hydroxyvitamin D, parathyroid hormone, glucose, calcium, phosphorus, creatinine, and alanine aminotransferase were determined and compared. And adverse reactions were observed and recorded. RESULTS There were 20 patients completed the trial in the treatment group and 20 patients in the control group, respectively. The average time to reach targeted serum concentration of 25-hydroxyvitamin D was(11.9±3.2) month. So the various indicators at 12 months of observation were taken for statistics in the control group. The serum levels of 25-hydroxyvitamin D after treatment in the treatment group were significantly higher than those in the control group((31.55±1.95) μg·L^(-1) vs.(12.82±1.93) μg·L^(-1), P < 0.01), and serum levels of PTH in the treatment group were significantly lower than those in the control group((37.69±12.68) pg·mL^(-1) vs.(49.38±14.94) pg·mL^(-1), P < 0.05). But there was no significant difference in serum glucose, calcium, phosphorus, creatinine, and alanine aminotransferase between two groups(all P > 0.05). No serious adverse reaction occurred in treatment group. CONCLUSION Vitamin D_(2) injection is helpful for decreasing serum PTH level in very elderly men with vitamin D deficiency.