甲状腺疾病与血清骨钙素的关系及其临床意义

Study of Serum BGP Levels in Patients with Thyroid Diseases

观察各种甲状腺疾病治疗前、后血清骨钙素的变化 ,以探讨甲状腺功能异常与骨代谢的关系。本文对2 36例甲状腺疾病患者及 5 2名健康志愿者为对照组 ,采用酶放大化学发光法测定了血清骨钙素 (BGP)、FT3 、FT4、TSH和人甲状腺球蛋白 (HTG)。结果显示 :正常人血清骨钙素水平随着年龄的增高而逐渐降低 ;甲亢患者治疗前BGP浓度明显升高 ;甲减患者治疗前BGP浓度明显低于正常 ,经短期甲状腺素替代治疗后 ,BGP浓度明显高于正常 ;治疗前的亚甲炎患者BGP浓度明显高于对照组 ,用糖皮质激素治疗后 ,BGP浓度反低于正常水平。相关统计表明 ,治疗前、后的甲亢、甲减和亚甲炎患者BGP与FT3 、FT4之间呈明显的正相关 ;甲减患者BGP与TSH呈负相关。实验结果显示甲状腺激素可能直接参与加速骨转换过程 ,并以增加骨吸收过程为显著 ;糖皮质激素可使骨转换率减低 ,骨的形成降低 ,最终都可能导致骨矿丢失。

To study changes of serum BGP level on a variety of thyroid diseases before and after therapy so as to investigate the relationship between thyroid dysfunction and bone metabolism,serum BGP, FT 3, FT 4, TSH and HTG were measured by immulite in 236 patients with thyroid diseases and 52 healthy volunteers control.The results indicated that the serum BGP level was decreased with age increasing in control. Serum concentration of BGP was significantly higher in untreated hyperthyroid patients than that in control. In hypothyroidism patients before treatment, serum BGP was notably lower than that in control( P <0.01).After replacement therapy using thyroid hormone for a short term, serum BGP level was elevated significantly. In subacute thyroiditos patients before therapy,serum BGP was much higher than that in control, and remarkably decreased after therapy with corticoids in contrast to control.The correlation analysis showed that BGP was positively correlated with FT 3, FT 4 in patients with hyperthyroidism, hypothyroidism and subacute thyroiditis. BGP level was negatively correlated with TSH in patients with hypothyroidism.Thyroid hormone might speed up bone turnover directly with increased bone resorption to induce bone mass loss. Corticoids hormone remarkably decreased bone turnover and induce bone mass loss.