女性Graves患者骨密度、骨代谢特点及^(131)I治疗后的转归分析  

The analysis of bone mineral density and bone metabolism in female patients with Graves' disease and the changes after ^(131)I therapy

作　　者：吴立兵[1] 刘刚[1] 谭凡[1] 万华兵[1] 

机构地区：[1]十堰市太和医院(湖北医药学院附属医院),湖北十堰442000

出　　处：《中国骨质疏松杂志》2016年第2期207-210,共4页Chinese Journal of Osteoporosis

摘　　要：目的研究女性Graves患者的骨密度、骨代谢指标及131I治疗后的变化情况,为Graves患者骨代谢异常的诊治提供科学的临床依据。方法回顾性分析2013年5月至2015年5月期间,经我院131I治疗的90例女性Graves患者的资料,根据患者绝经情况,分为绝经组和未绝经组,各45例。两组患者治疗前、后均采用双能X线骨密度仪对腰椎、髋部行骨密度(BMD)测量并检测血钙(Ca)、磷(P)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、血骨钙素(BGP)等骨代谢指标,记录并行统计学分析。结果治疗前,绝经组所测部位的BMD略低于未绝经组,骨代谢指标略高于未绝经组,差异无统计学意义(P>0.05);治疗后,未绝经组骨密度的改善效果强于绝经组与治疗前,髋部及腰部BMD明显上升,ALP、BGP水平明显降低,统计学差异显著(P<0.05),但两组血Ca、P、PTH的差异无统计学意义(P>0.05)。结论131I治疗可以改善女性Graves患者的骨密度及骨代谢情况,对指导防治骨质疏松起着积极的作用。Objective To analyze the changes of bone mineral density （BMD） and bone metabolism index in female patients with Graves and after treatment of ^131I, and to provide scientific clinical evidence for the treatment of bone metabolic disorder in patients with Graves＇ disease. Methods Data of 90 female patients with Graves＇ disease after ^131I treatment in our hospital from May 2013 to May 2015 were retrospectively analyzed. According to their menopause status, the patients were divided into postmenopausal group and premenopausal group, with 45 cases in each group. BMD of the lumbar spine and hip in patients of two groups was measured before and after the treatment using dual energy X-ray absorptiometry. Serum calcium （CA）, phosphorus （P）, parathyroid hormone （PTH）, alkaline phosphatase （ALP）, and osteocalcin （BGP） were detected. Results Before the treatment, BMD in postmenopausal group was slightly lower, but the bone metabolism index were slightly higher than that in premenopausal group, with no significant statistical difference （ P 〉 0.05 ）. After the treatment, the improvement in premenopausal group was more than the in postmenopausal group and before treatment. BMD of the hip and waist increased significantly. Levels of ALP and BGP decreased significantly, with statistical difference （P 〈 0.05 ）. The levels of serum Ca, P, and PTH were not significantly different between the two groups （P 〉 0. 05）. Conclusion ^131I therapy can improve BMD and bone metabolism in female patients with Graves＇ disease and has a positive influence in prevention of osteoporosis.

关 键 词：女性 Graves病 ^131I 骨密度 血清骨代谢指标 

分 类 号：R581.1[医药卫生—内分泌]