特发性甲状旁腺功能减退症骨密度改变及甲状旁腺激素缺乏对骨量的影响研究  

Change of bone mineral density in patients with idiopathic hypoparathyroidism and influensence of PTH deficiency on bone mass

作　　者：张凤丽[1] 邢小平[2] 王鸥[2] 李梅[2] 孟迅吾[2] 周学瀛[2] 

机构地区：[1]首都医科大学附属北京安贞医院普内科,北京100029 [2]中国医学科学院中国协和医科大学北京协和医院内分泌科,北京100730

出　　处：《中国实用内科杂志》2010年第5期429-431,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的评价特发性甲状旁腺功能减退症(简称特发甲旁减)的骨密度(BMD)改变,探讨长期甲状旁腺激素(PTH)缺乏对骨量的影响。方法回顾性分析1996—2006年北京协和医院诊治的71例特发甲旁减患者的病历资料,测定患者腰椎及股骨近端BMD,比较患者与健康志愿者及治疗时间<1年与治疗时间≥1年患者的BMD。结果特发甲旁减患者腰椎和股骨近端BMD均显著增高(P<0.01),各部位BMD均值较健康志愿者增加14.2%～31.9%。治疗时间<1年和治疗时间≥1年患者BMD比较差异无统计学意义(P>0.05)。结论特发甲旁减患者腰椎和髋部BMD值均显著增加,未发现钙剂和维生素D制剂治疗对其有显著影响,患者BMD增高的原因主要为PTH不足。Objective To evaluate the BMD changes in patients with idiopathic hypoparathyroidism and to analyze the influence of long term PTH deficiency on bone mass. Methods Seventy-one patients with idiopathic hypoparathyroidism admitted in PUMCH were retrospectively analyzed. BMD was measured at lumbar spine and proximal femur. BMD of patients with idiopathic hypoparathyroidism was compared with that of healthy individuals. Comparison of BMD was also done between patients treated for less than one year and patients or more than one year. Results Patients with idiopathic hypoparathyroidism showed significantly higher BMD at lumbar spine and proximal femur compared with the healthy adults （ P 〈 0. 001 ）. The percentage of mean BMD values increased from 14. 2% tO 31.9%. There was no significant difference in BMD values between patients treated for less than one year and patients treated for one or more than one year （ P 〉 0. 05 ）. Conclusion BMD at lumbar spine and proximal femur of idiopathic hypoparathyroidism patients was significantly higher than that of the healthy volunteers. This study did not find significant effect of calcium and vitamin D treatment on BMD of hypoparathyroidism patients. The increased BMD of idiopathic hypoparathyroidism patients was caused mainly by PTH deficiency.

关 键 词：甲状旁腺激素 特发性甲状旁腺功能减退症 骨矿盐密度 

分 类 号：R5[医药卫生—内科学]