不同甲状腺功能状态尿DPD、血清BGP的变化及意义

Changes of urinary DPD,serum BGP in different conditions of thyroid function and its significance

目的 探讨不同甲状腺功能状态下尿脱氧吡啶啉 (DPD)、血清骨钙素 (BGP)的变化及意义。方法 选择 92例甲状腺功能亢进症 (简称甲亢 )患者 ,分三组 ,A组 :初发甲亢 30例 ,有甲亢高代谢症群 ,FT3 、FT4明显增高 ;B组 :35例 ,抗甲状腺药物治疗 3个月 ,甲亢症状明显好转 ,FT3 、FT4基本恢复正常 ;C组 :2 7例 ,甲亢治疗 1年以上 ,FT3 、FT4均已恢复正常。正常对照组4 0例 ,全部受试者均测定FT3 、FT4、尿DPD、血清BGP、骨密度 (BMD)、血钙 (Ca)、磷 (P)、碱性磷酸酶 (ALP)等。结果 在A组和B组中 ,DPD、BGP、ALP各均值显著高于正常对照组 (P <0 0 1～ 0 0 0 1) ;A组与B组之间差异有非常显著性 (P <0 0 5～ 0 0 1) ;A组及B组的BMD较正常对照组低 ,而A组与B组比较差异无显著性 ,C组与A组比较差异有显著性 (P <0 0 5 )。相关分析显示 ,FT3 、FT4分别与尿DPD、血BGP、ALP成正相关 (P <0 0 5～ 0 0 1) ,与BMD无明显相关。结论 甲亢患者常伴有骨吸收及骨形成的增加 ,且骨吸收大于骨形成 ;尿DPD和血清BGP对早期诊断甲亢性骨病有参考价值 。

Objective To assess changes of urinary deoxypyridinoline(DPD) and serum osteocalcin(BGP) concerning different thyroid function conditions and its significance.Methods Ninety two hyperthyroid patients were selected randomly and were divided into 3 groups.Thirty incipient hyperthyroid patients in group A have hypermetabolism signs and obvious increasing of FT 3,FT 4,35 patients in group B were treated with antithyroid drug for 3 months, their symptoms were improved significantly,FT 3,FT 4 almost recovered to normal level.In group C,27 patients already had normal FT 3,FT 4 level after more than 1 years treatment.There were 40 in normal control group.FT 3?FT 4?urinary DPD?serum BGP?bone mineral density(BMD)?blood calcium(Ca)?phosphorus(P)?Alkaline phosphatase(ALP)were determined in all objects.Results DPD,BGP,ALP in groups A and B were higher significantly than those in normal control group( P <0.01～0.001),there was a significant difference between group A and B( P <0 05～0 01).BMD in group A and B were lower than those in control group,there was not obvious difference between group A and B,but a notable difference between group A and C( P <0 05).The correlation analysis shows that FT 3,FT 4 were positively correlated with DPD?BGP?ALP( P <0 05～0 01),but not with BMD.Conclusion In the patients with hyperthyroid,both bone resorption and bone formation were increased,and the resorption is more than formation.Urinary DPD,serum BGP are sensitive and specific index for hyperthyorid osteopathy early diagnosis,they also may be taken as index for patient condition follow up.