老年人甲状腺激素与钙、磷代谢及骨代谢关系的研究

Study on the relationship between thyroid hormone and calcium, phosphorus and bone metabolism

目的 探讨老年人甲状腺激素(TH)水平与钙、磷代谢及骨代谢关系。方法 选择健康老年治疗组和对照组各60例。治疗组口服甲状腺片10mg·d^(-1),对照组口服VitB_1 30mg·d^(-1),连服6月,所有的受试者治疗前后均检测TH包括促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、总三碘甲状腺原氨酸(TT_3)、总甲状腺素(TT_4)、反三碘甲状腺原氨酸(rT_3)和血钙(Ca)、血磷(P)代谢以及骨代谢生化指标包括骨钙素(BGP)、骨碱性磷酸酶(BALP)、I型前胶原羧基肽(PICP)及尿羟脯氨酸/肌酐(Hop/Cr)、尿胶原吡啶交联/肌酐(Pyd/Cr)的水平并比较它们之间的关系。结果 治疗组TH水平有明显升高,血清Ca、BGP、BALP、PICP的水平也有明显升高,而P的水平、Pyd/Cr、Hop/Cr值则有一定程度的降低,与治疗前比较有显著性差异。对照组服药前后各项指标无显著性差异。结论 给予老年人小剂量的TH补充治疗,可升高血清中TH水平和Ca、BGP、BAL、PICP的水平,降低P的水平、Pyd/Cr、Hop/Cr值,对骨的形成有利。

Objective Using small doses of thyroid hormone(TH) to observe the relationship between TH level and calcium, phosphorus and bone metabolism in the elderly. Methods Sixty healthy elderly cases were chosen as treatment group and 60 as control group.The treatment group took thyroid tablet 10mg daily continuously for six months while the control group took VitB1. All subjects were measured for the level of TSH, FT3, FT4, TT4, rT3, calcium, phosphorus and the values of bone metabolism (including BGP,BALP,PICP,Hop/Cr,Pry/Cr)before and after treatment and the results were analyzed. Results The level of TH increased obviously in treatment group compared with control group.The levels of calcium, BGP, BALP,PICP incerased after taking TH tablets, while the values of Hop/Cr,Pty/Cr and the level of phosphorus decreased. Conclusions Small doses of TH as supplement could increase the level of TH, calcium, BGP, BALP,PICP, whereas the level of phosphorus and values of Hop/Cr, Pty/Cr decrease.