女性毒性弥漫性甲状腺肿患者骨密度特点  

Characteristics of bone mineral density in women with Graves' disease

作　　者：陈玮[1] 吴玉洁[1] 董林[1] 杨光伟[1] 王计艳[1] 陈超[1] 邢学农[1] 任安[1] 

机构地区：[1]安徽医科大学附属省立医院,安徽省立医院内分泌科,合肥230001

出　　处：《中国临床保健杂志》2013年第2期153-155,共3页Chinese Journal of Clinical Healthcare

基　　金：安徽省科技厅年度重点项目(11070443029)

摘　　要：目的观察绝经前后女性毒性弥漫性甲状腺肿(GD)患者骨密度,分析甲状腺激素水平与骨密度之间的相关性。方法使用双能X线骨密度仪测定318例女性(GD患者242例,对照组76例)桡骨全部、腰椎2-4及股骨颈三个部位骨密度。用化学发光法测定GD患者的游离三碘甲腺原氨酸(FT3)、游离甲状腺激素(FT4)及促甲状腺激素(TSH)。结果绝经前GD患者桡骨全部、腰椎2-4、股骨颈的骨密度均显著低于绝经前对照组(P<0.01),而绝经后GD患者仅桡骨全部的骨密度显著低于绝经后对照组(P<0.01)。绝经后GD患者与绝经前GD患者比较,以及绝经后对照组与绝经前对照组比较,三个部位骨密度均明显下降(P<0.01)。结论 GD影响女性的骨健康状况,尤其对前臂骨影响更显著。绝经后GD患者除甲状腺激素对骨量的负性影响外,雌激素的缺乏也是影响骨密度的重要因素,雌激素缺乏可加剧GD对骨代谢的负影响。Objective To observe bone mineral density （BMD）in the premenopausal and postmenopausal women with Graves＂ disease and analysize the relationship between thyroid hormone and BMD. Methods BMDs of forearm,lumbar vertebrae, and the neck of femur were measured using dual-energy X-rays absorptiometry （DEXA） in 318 women （242 GD ,78 normal subjects ）. Free triiodothyronine （FT3）, free thyroxine （FF4 ）, and thyroid stimulating hormone （TSH） levels were measured using chemiluminescence method. Results The BMDs of forearm, lumbar verte- brae 2-4, and femur neck in premenopausal patients with GD were significantly lower than premenopausal controls, but postmenopausal patients with GD only had lower forearm BMD than postmenopausal controls. Compared to prem- enopausal women,including patients and controls, postmenopausal women had lower BMD of three measurement sites. Conclusion This study indicates that GravesJdisease affects bone metabolism especially during postmenopausal peri- od. This effect is mainly at the cortical bone. Both excessive thyroid hormone and estrogenic deficiency are associated with low BMD,which suggest estrogenic deficiency may increase the negative effect of hyperthyroidism on bone metab- olism.

关 键 词：格雷夫斯病 骨密度 雌激素 骨质疏松 女(雌)性 

分 类 号：R581.3[医药卫生—内分泌]