甲亢患者I^(131)治疗和药物治疗后对骨代谢指标的影响

Effects of I^(131) therapy and drug therapy on bone metabolism in hyperthyroidism patients

目的分析甲状腺功能亢进(以下简称“甲亢”)患者在I^(131)治疗和药物治疗后不同甲状腺功能状态骨代谢指标的变化。方法回顾性分析该院2020年9月1日到2021年2月22日因I^(131)治疗和药物甲巯咪唑治疗甲亢患者108例,经治疗后患者不同甲状腺功能状态下维生素D(VitD),骨钙素N端中分子片段(N-MID Ost),β胶原降解产物(β-CTx)和总Ⅰ型胶原氨基端延长肽(P1NP)指标浓度的变化,以及比较两组治疗方法之间指标浓度的差异。结果I^(131)治疗和药物甲巯咪唑治疗后甲状腺功能亢进组N-MID Ost,β-CTx,P1NP明显高于亚临床甲亢组和甲状腺功能健康组,比较差异有统计学意义(P<0.05);三组VitD比较无统计学意义(P>0.05)。两种治疗方法对甲状腺功能处于同水平N-MID Ost,β-CTx和P1NP指标浓度无统计学意义(P>0.05)。结论甲亢患者治疗后仍处于甲状腺功能亢进时,骨吸收标志物β-CTx和骨形成标志物N-MID Ost,P1NP都是增高。随着患者甲状腺功能恢复正常,骨吸收标志物和骨形成标志物都呈降低趋势。提示患者在甲状腺功能亢进控制以后存在骨形成不足。

Objective To analyze the changes of bone metabolic indexes in different thyroid function states in patients with hyperthyroidism after I^(131) treatment and drug therapy.Methods The changes of vitamin D(VitD),osteocalcin N-terminal middle molecular fragment(N-MID Ost),β-collagen degradation product(β-CTx)and total type I collagen N-terminal extension peptide(P1NP)in patients with hyperthyroidism treated with I^(131) and methimazole from September 1,2020 to February 22,2021 were analyzed retrospectively.And compare the difference of index concentration between the two groups.Results N-MID Ost and β-CTx,P1NP in patients with hyperthyroidism after treatment with I^(131) and methimazole were significantly higher than those with subclinical hyperthyroidism group(P<0.05)and normal thyroid function,but there was no significant difference in VitD among the three groups(P>0.05).There was no significant difference in the concentrations of N-MID Ost,β-CTx and P1NP at the same level between the two treatments(P>0.05).Conclusion When the hyperthyroidism patients are still in hyperthyroidism after treatment,the bone resorption marker β-CTx and the bone formation marker Nmuri MID Ost,P1NP are increased.As the thyroid function of the patients returned to normal,the markers of bone resorption and bone formation decreased.It is suggested that the patients have insufficient bone formation after the control of hyperthyroidism.