甲亢^(131)Ⅰ治疗前后骨密度及相关指标变化分析  

Changes of bone mineral density and related parameters in patients of hyperthyroidism before and after ^(131)Ⅰ therapy

作　　者：高继兵[1] 蔡善武[1] 黄海泉[2] 吕雪峰[2] 陈继中[3] 李旭光[3] 

机构地区：[1]铜陵市人民医院核医学科,244000 [2]铜陵市人民医院内分泌科,244000 [3]铜陵市人民医院检验科,244000

出　　处：《中华核医学杂志》2005年第4期237-239,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨131Ⅰ治疗甲状腺功能亢进(简称甲亢)对骨代谢的影响。方法58例甲亢患者治疗前、治疗后3及6个月分别检测其血清TT3、TT4、sTSH、骨钙素(BGP)、甲状旁腺素(PTH)和降钙素(CT)浓度,用全自动生化仪测定血清碱性磷酸酶(ALP)、血清钙(Ca)和无机磷(P)的含量,治疗前后均采用双能X线检测其前臂、腰椎(L2-L4)及股骨上段的骨密度(BMD)值。结果①甲亢131Ⅰ治疗后6个月(除无效组外)与治疗前及治疗后各组与无效组的各部位平均BMD值比较差异有显著性(P<0.05);②甲亢131Ⅰ治疗后6个月BGP、CT、CT/PTH比值、ALP和Ca与治疗前及治疗后各组与无效组比较差异有显著性(P<0.01或P<0.05);③治疗前血清TT3水平与血清BGP呈正相关(r=0.4113,t=2.9896,P<0.005);血清Ca与TT3水平及CT/PTH比值呈正相关(r值分别为0.3613和0.3915,t值分别为2.6836和2.9639,P<0.01和<0.005)。结论131Ⅰ治疗甲亢患者能使其骨代谢指标在短时间里有较好恢复。Objective To investigate the changes of bone metabolism in patients with hyperthyroidism before and after ^131I therapy. Methods The serum levels of TT3 , TT4, sensitive thyroid-stimulating hormone （sTSH） , bone gla protein （BGP） , parathyroid hormone （PTH） and calcitonin （CT） of 58 patients with hyperthyroidism were measured andalso the serum alkaline phosphatase （ALP） , qaleium （Ca） and phosphorus （P） levels. The bone mineral density （BMD） of the forearm, lumbar（ L2 -L4 ） and femur was obtained by dual photon X-ray before and after ^131I therapy. Results ①Both BMD between the patients treated after 6 months, and before treatment, also the BMD between various ^131I treated group and no response group had significant differences （ P 〈 0.05 ）. ②There were also significant differences in the serum BGP, CT, CT/PTH, ALP and Ca level （P 〈 0.01 or P 〈 0. 05）. ③The serum TT3 level before therapy was positively correlative to the serum BGP （ r = 0. 4113 ,t = 2. 9896, P 〈 0.005 ） , and the serum Ca level was positively correlative to TT3 and CT/PTH radio （ r = 0. 3613, t = 2. 6836, P 〈 0.01 and r = 0. 3915, t = 2.9639, P 〈0.005 respectively）. Conclusion BMD and other bone metabolic parameters of hyperthyroidism patients can resume to normal in a short period of time after ^131T therapy.

关 键 词：甲状腺功能亢进症 放射疗法 骨密度 骨钙素 甲状腺激素类 碘放射性同位素 甲亢^131I 治疗前后 变化分析 血清碱性磷酸酶 

分 类 号：R581.1[医药卫生—内分泌]