Graves病患者骨代谢指标的变化  

Changes of Biochemical Markers of Bone Turnover in Patients with Graves' Disease

作　　者：王转锁[1] 宋钦华[1] 吴月平[1] 陈竑[1] 谭丽玲[1] 孙胜花[1] 

机构地区：[1]海南医学院附属医院内分泌科,570102

出　　处：《天津医药》2014年第7期683-686,共4页Tianjin Medical Journal

基　　金：海南省高等学校科学研究项目(Hjkj2011-27)

摘　　要：目的观察Graves病患者血中钙、磷、碱性磷酸酶(ALP)、甲状旁腺素(PTH)和25羟维生素D[25(OH)D]水平变化及在骨代谢中的作用。方法收集62例初发或复发的Graves病患者及91例正常对照人群资料。电化学发光法测定血浆PTH和25(OH)D;生化法测定血钙、磷、ALP。结果 Graves病组血钙、磷、ALP、25(OH)D水平升高,PTH降低(均P<0.01)。亚组分析显示,女性患者血钙、磷、ALP、25(OH)D水平高于对照组,PTH水平低于对照组;男性患者ALP、25(OH)D水平高于对照组,PTH水平低于对照组(均P<0.01)。Graves病组维生素D缺乏17例(27.4%),不足20例(32.3%),充足25例(40.3%);对照组维生素D缺乏54例(59.3%),不足31例(34.1%),充足6例(6.6%)。Graves病组血PTH、血25(OH)D、血钙及血磷无相关性。结论 Graves病骨转换加速,患者血25(OH)D水平升高,可能与高血钙、血PTH降低、高血磷导致1-α-羟化酶活性降低有关。维生素D缺乏在Graves病骨代谢中的作用不大。Objective To observe the serum levels of calcium, phosphorus, alkaline phosphatase （ALP）, parathy-roid hormone （PTH） and 25-hydroxyvitamin D, and the influence of biochemical markers of bone turnover in Graves’dis-ease. Methods Sixty-two patients with Graves’disease were enrolled into the Graves’disease group and 91 healthy indi-viduals as a control group. Electrochemical luminescence was used to evaluate the plasma levels of PTH and 25-hydroxyvita-min D in two groups. The serum levels of calcium, phosphorus and ALP were measured with biochemistry methods in two groups. Results The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in the Graves’disease group compared with those in control group （P〈0.01）. The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in female patients than those of control group, and the level of PTH was lower than that of control group. For male patients, the levels of ALP and 25-hydroxyvitamin D were higher than those of control group, and the level of PTH was lower than that of control group. In Graves’disease group, patients with vitamin D deficien-cy were 17 cases （27.4%）, insufficiency 20 cases （32.3%） and sufficiency 25 cases （40.3%）, respectively. In control group, there were 54 cases with vitamin D deficiency （59.3%）, 31 cases with insufficiency vitamin D （34.1%） and 6 cases with suffi-ciency vitamin D （6.6%）, respectively. There was no correlation in plasma levels of PTH, 25-hydroxyvitamin D, serum calci-um and serum phosphorus in Graves’disease group. Conclusion The bone turnover is accelerated in Graves’disease. The increased plasma level of 25-hydroxyvitamin D is related with increased calcium level and decreased PTH level in Graves’ disease. The increased serum phosphorus reduces 1-α-hydroxylase activity. Vitamin D deficiency plays a minor role in bone metabolism of Graves’disease.

关 键 词：格雷夫斯病 甲状旁腺素 钙 磷 碱性磷酸酶 25羟维生素D 骨代谢 

分 类 号：R581.1[医药卫生—内分泌]