绝经前后甲状腺功能亢进患者骨密度影响因素相关性分析  

Correlation Analysis on the Influencing Factors of Bone Mineral Density in Patients with Hyperthyroidism Before and After Menopause

作　　者：文莉[1] 张波[2] 易念华[1] 

机构地区：[1]湖北省妇幼保健院妇女保健科,武汉430070 [2]广州军区武汉总医院呼吸内科,武汉430070

出　　处：《医学综述》2014年第23期4394-4395,共2页Medical Recapitulate

摘　　要：目的探讨分析绝经前后女性甲状腺功能亢进(甲亢)对骨密度的影响。方法选取2010年4月至2011年2月在湖北省妇幼保健院就诊的60例女性甲亢患者为研究对象,其中绝经期30例(甲亢A组),生育期30例(甲亢B组);另选择同期体检的60例健康女性作为对照,其中绝经期30例(健康A组),生育期30例(健康B组)。测定女性甲亢患者与健康者的骨密度,并进行比较。结果甲亢组患者游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸显著高于健康组(P<0.05),腰椎、股骨的骨密度显著低于健康组(P<0.05);线性回归分析结果显示:甲亢组患者的骨密度与绝经年限,病程,血清FT3水平呈负相关(P<0.05),与血清促甲状腺激素(TSH)水平呈正相关(P<0.05);Logistic回归分析结果显示:绝经年限、病程、FT3可能是导致女性甲亢患者并发骨质疏松的独立危险因素(P<0.05),TSH是女性甲亢患者并发骨质疏松的独立保护因素(P<0.05)。结论女性甲亢患者的骨密度显著低于正常的健康女性,尤其是绝经后患者更明显,故对绝境后女性甲亢患者治疗过程中需要注意骨质疏松的发生。Objective To study on the impact of hyperthyroidism on bone mineral density in patients before and after menopause. Methods A total of 60 cases of female patients with hyperthyroidism admitted in Hubei Provincial Maternal and Child Health Hospital from Apr. 2010 to Feb. 2011 were selected as the hyperthyroidismgroup, including 30 cases of postmeanpansal women （hyperthyroidism group A）, and 30 cases of women at reproductive age （ hyperthyroidism group B ） ; another 60 healthy women underwent physical examination in the hospital during the same period were selected as the control group, including 30 cases of postmenopausal women （healthy group A）, and 30 cases of women at reproductive age （healthy group B）. The bone mineral density was tested among the patients with hyperthyroidism and the healthy females. Results In the hyperthyroidism group, levels of free triiodothyronine （ FT3 ）, free tetraiodothyronine （ FT4 ） were significantly higher than the healthy group（ P 〈 0.05 ）, bone mineral density of lumbar and femur was significantly lower than the healthy group （P 〈 0.05 ）. Results of linear regression analysis showed that bone mineral density of patients with hyperthyroidism had negative correlation with menopausal years, course of disease, serum FT3 level（ P 〈 0.05 ） , and had positive correlation with serum thyroid-stimulating hormone（TSH） level（ P 〈 0.05 ） ; results of multivariate logistic analysis showed that menopausal years, course of disease, FT3 may be the independent risk factors of osteoporosis in female patients with hyperthyroidism（ P 〈 0.05 ）, and TSH is the independent protective factor of osteoporosis in female patients with hyperthyroidism （ P 〈 0.05 ）. Conclusion The bone mineral density of patients with hyperthyroidism was obviously lower than the healthy females, especially lower in women after menopause. Therefore, treatment for patients with hyperthyroidism after menopause needs to prevent the occurrence of osteoporosis.

关 键 词：绝经期 甲状腺功能亢进症 骨密度 

分 类 号：R271.1[医药卫生—中医妇科学]