摘要
目的探讨初诊甲亢患者药物抗甲亢治疗前后骨密度和骨代谢生化指标的变化。方法选取2014年1-3月于北京大学深圳医院内分泌科门诊初诊甲状腺功能亢进症(甲亢)病例共32例为研究组,选取年龄、性别匹配健康体检者30名作正常对照组,测定患者治疗前后血清碱性磷酸酶(ALP)、钙、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、血清骨钙素(N-MID)、β-胶原特殊序列(β-CTX)以及总I型胶原氨基端延长肽(PINP)及股骨颈骨密度(BMD),并进行比较分析。结果甲亢组患者血清ALP、钙、β-CTX、N-MID、PINP较正常对照组明显升高(P<0.05);经治疗后,血清ALP、钙、β-CTX、N-MID及PINP较治疗前明显降低(P<0.05),但与正常组相比,N-MID和PINP仍升高(P<0.05)。甲亢组较正常对照组股骨颈BMD明显降低(P<0.05);治疗后BMD明显升高(P<0.05);但与正常对照组相比,甲亢组治疗后的BMD仍显著降低(P<0.05)。PINP、β-CTX与FT3、N-MID与FT4均呈正相关,与TSH均呈负相关(P<0.05);N-MID与股骨颈BMD呈负相关(P<0.05)。结论积极抗甲亢治疗可有效降低骨形成和骨吸收标记物水平,预防出现高转换型骨质疏松。
Objective To evaluate the effect of medical treatment on bone mineral density（BMD） and bone metabolism in newly diagnosed hyperthyroidism subjects. Methods 32 cases of newly diagnosed hyperthyroidism patients in our hospital from January 2014 to March were selected as hyperthyroidism group;30 cases of age and sex-matched healthy people were selected as control group. Serum alkaline phosphatase （ALP）, calcium, three free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid stimulating hormone （TSH）, serum osteocalcin （N-MID）, β-collagen specific sequence （β-CTX） and total amino-terminal extension of type I collagen peptides （PINP） and femoral neck bone mineral density （BMD） before and after treatment were measured and analyzed. Results Hyperthyroid patients serum ALP, calcium, β-CTX, N-MID and PINP were significantly higher than normal control group （P〈0.05）.After treatment, serum ALP, calcium, β-CTX, N-MID and PINP were significantly lower than before treatment （P〈0.05）,but compared with the normal group, N-MID and PINP were still higher（P〈0.05）.Hyperthyroidism femoral neck BMD was significantly lower than that of normal （P〈0.05）,but was significantly increased after treatment （P〈0.05）.However, compared with the control group, BMD of hyperthyroidism group after treatment remained significantly lower （P〈0.05）. PINP, β-CTX, FT3 and N-MID showed a positive correlation with FT4, and negatively correlated with TSH （P〈0.05）; N-MID and femoral neck BMD was negatively correlated （P〈0.05）. Conclusion Positive antithyroid therapy could effectively reduce bone formation and resorption marker levels,and prevent the emergence of high-turnover osteoporosis.
作者
吴佩娴
张帆
蓝薇
戴亚丽
陈说
郇婕
叶敏
WU Pei-xian ZHANG Fan LAN Wei DAI Ya-li CHEN Shui HUAN Jie YE Min(Department of Endocrinology, Peking University Shenzhen Hospital ,Shenzhen Guangdong 518036,China)
出处
《热带医学杂志》
CAS
2016年第11期1399-1401,1405,共4页
Journal of Tropical Medicine
关键词
甲亢
骨质疏松
骨密度
骨代谢标记物
Hyperthyroidism
Osteoporosis
Bone mineral density
Bone metabolism marker
