甲亢术后不同时期骨密度及骨代谢生化指标的变化

Changes of bone Mineral Density and Bone Metabolism in Different Period after Operation in Patients with Hyperthyroidism

目的 :探讨甲亢患者术后不同时期骨密度及骨代谢生化指标的改变。方法 :研究病例分为治疗组及对照组 ,治疗组术后早期予钙剂及 D剂治疗 ,并进一步对所有病例于术后早期 (1周 )、中期 (1个月 )、远期 (3个月 )进行骨密度 (BMD)测定及血清甲状旁腺素 (PTH)、碱性磷酸酶 (AKP)、降钙素 (CT)、骨钙素 (BGP)、 型胶原 C端肽 (CTX)、血、尿钙、磷的检测。结果 :甲亢术后血 AKP、PTH/ CT、CTX、BGP与 BMD呈明显负相关性。表明甲亢术后骨转换仍处于活跃状态 ,骨吸收增强 ,仍有骨量的丢失 ;而治疗组在应用药物后骨转换下降 ,不再有骨量的继续丢失 ,骨密度渐恢复。结论 :对伴有骨量丢失的甲亢患者在选择手术治疗的同时应适时予钙剂及 D剂治疗以纠正由此引起的骨病。

Objective:To investingate the changes of bone mineral density (BMD) and bone metabolism in different period after operation in patients with hyperthyroidism.Methods:Patients were divided into experimental group and control group.The experimental group were given calcium and vit-D in the early period after operation and BMD,PTH,AKP,CT,BGP,CTx,the levels of blood′s Ca and P in both groups were measured 1 week,1 month and 3 months after operation were measured.Results:The levels of blood′s AKP, PTH/CT, CTx, BGP showed negative relations to BMD in patients after operation, meaning active bone turn over,strong bone absorption and continued bone loss; but in experimental group bone turn-over declined and bone didn′t lose,and bone density recovered.Conclusion:Patients with hyperthyroidism complicated with bone lossshould be supplemented with Ca and Vit D after operation in order to correct possible osteopathia.