定量骨超声对诊断甲状腺功能亢进症患者骨代谢异常的意义  

Significance of ultrasound bone measurement in diagnosis of hyperthyroidism

作　　者：康东红[1] 邱明才[1] 曹平[1] 刘苹[1] 

机构地区：[1]天津医科大学总医院内分泌科

出　　处：《中华医学杂志》2005年第12期831-834,共4页National Medical Journal of China

摘　　要：目的探讨定量骨超声在甲状腺功能亢进症(甲亢)骨代谢异常中的意义.方法选择118例甲亢患者,用Sunlight-Ominisense超声骨强度仪检测其桡骨、胫骨超声波传导速度(SOS),双能X线骨密度仪测定其腰椎、股骨近端骨密度.用放射免疫方法测定血清总甲状腺素(TT4),总三碘甲状腺原氨酸(TT3),游离甲状腺素(FT4),游离三碘甲状腺原氨酸(FT3) 和促甲状腺激素(TSH)的水平.血生化的方法测定血碱性磷酸酶.结果与正常对照比较,甲亢患者胫骨和桡骨SOS降低(40～50岁:3809±171 vs. 3955±102,3881±713 vs.4187±114;50～60岁:3721±223 vs. 3852±102,3875±201 vs.4035±114),差异均有统计学意义(均P<0.05);SOS与骨密度呈显著性正相关(P<0.05);甲亢胫骨和桡骨SOS异常的发生率(Z值≥-1的发生率分别为41.2%、43.3%,-2.5＜Z值＜-1的发生率40.2%、33.0%, Z值≤-2.5的发生率分别为18.6%、23.7%)高于腰椎(L2-4: 57.6%、34.7%、 7.6%)和股骨近端(74.8%、23.4%、1.8%)骨密度,差异有统计学意义.SOS与碱性磷酸酶呈负相关(P<0.05).结论定量骨超声是诊断甲亢骨代谢异常有价值的指标.Objective To evaluate the role of ultrasound in bone density measurement in patients with hyperthyroidism. Methods The speed of sound (SOS) through distal radius and midshaft tibia of 118 patients with hyperthyroidism 138 males and 80 females, aged 20~73, were measured with ultrasonic apparatus, the bone mass density (BMD) was measured at the lumbar spine and proximal femur with dual energy X-ray absorptiometry, the serum levels of total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH) were measured by radioimmunoassay, and alkaline phosphatase (ALP) was measured by routine method. Results The SOS of the patients with hyperthyroidism was significantly lower than that of the healthy subjects (P<0.05). A strong positive correlation was found between SOS and BMD. The prevalence of SOS (Z<-1, Z<-2.5) through distal radius and midshaft tibia was significantly higher than that of BMD (Z<-1, Z<-2.5) at lumbar spine and proximal femur in the patients with hyperthyroidism. A negative linear correlation was found between SOS and ALP. Conclusion SOS may be one of the significant markers for abnormal bone metabolism for hyperthyroidism.

关 键 词：定量骨超声 诊断 甲状腺功能亢进症 骨代谢异常 

分 类 号：R445.1[医药卫生—影像医学与核医学]