甲亢患者康复期血清甲状旁腺激素和骨代谢指标水平的变化及其临床意义  

Changes of serum parathyroid hormone and bone metabolic index levels of patients with hyperthyroidism in recovery stage and its clinical significance

作　　者：彭雪萍[1] PENG Xue-ping(Department of Endocrinology, the Third People＇s Hospital of Huizhou City, Huizhou 516002, China)

机构地区：[1]惠州市第三人民医院内分泌科,广东惠州516002

出　　处：《现代医学》2016年第9期1250-1254,共5页Modern Medical Journal

摘　　要：目的:探讨甲亢患者康复期血清甲状旁腺激素(PTH)和骨代谢指标水平的变化及其临床意义。方法:以甲亢患者48例为甲亢组和30例同期健康查体志愿者为对照组。检测比较2组血清PTH水平和血钙、血清骨钙素(OC)、骨桥蛋白(OPN)等骨代谢指标水平,统计甲亢组疗效,并分析其血清PTH和骨代谢指标水平与其疗效的关系和血清PTH水平与其血清骨代谢指标水平的关系。结果:与对照组比较,甲亢组治疗前和康复期的血钙水平和血清OC、OPN水平升高,血清PTH水平则降低;与治疗前比较,甲亢组康复期的血钙水平和血清OC、OPN水平降低,血清PTH水平则升高(P<0.05)。甲亢组治疗有效率为81.25%,且治疗有效患者血钙水平和血清OC、OPN水平较无效患者降低,血清PTH水平则较无效患者升高(P<0.05)。甲亢患者康复期血清PTH、血钙、血清OC、OPN水平与其治疗有效率均相关(P<0.05),且甲亢患者血清PTH水平与其血钙水平和血清OC、OPN水平亦均呈负相关(r=-0.786,-0.849,-0.887,P<0.05)。结论:甲亢可能通过影响甲状旁腺功能而影响患者的骨代谢和疗效,因此应积极治疗甲亢,减少其对患者甲状旁腺和骨代谢的影响以改善疗效。Objective： To investigate the changes of serum parathyroid hormone（ PTH） and bone metabolic index levels of patients with hyperthyroidism in recovery stage and its clinical significance. Methods： 48 cases of patients with hyperthyroidism were selected as the hyperthyroidism group,and the other 30 cases of healthy volunteers who had physical exam in the same period were selected as control group. Serum PTH levels and blood calcium,serum osteocalcin（ OC） and osteopontin（ OPN） and other bone metabolic index levels of the two groups were detected and compared. Curative effect of hyperthyroidism group was statistically analyzed. And the relationships between serum PTH and bone metabolism index levels with the curative effect and relationships between serum PTH level of the patients with hyperthyroidism with the serum bone metabolism index levels were analyzed. Results： Compared with control group,blood calcium and serum OC,OPN levels of hyperthyroidism group before treatment and in recovery stage were elevated while serum PTH level in the same period was lowered; Compared with before treatment,blood calcium and serum OC,OPN levels of hyperthyroidism groups in recovery stage were lowered while serum PTH level in the same period was elevated（ P〈0. 05）. Treatment effective rate of hyperthyroidism group was 81. 25%,and blood calcium and serum OC,OPN levels of the patients with effective treatment were lower than those of patients with invalid treatment,while serum PTH level of the patients with effective treatment was higher than that of the patients with invalid treatment（ P〈0. 05）. Serum PTH level,blood calcium levels and serum OC,OPN levels of the patients with hyperthyroidism in recovery period and its treatment efficiency was correlated. And serum PTH levels of the patients with hyperthyroidism in recovery stage were negatively correlated with blood calcium level and serum OC,OPN levels（ r =- 0. 786,- 0. 849,- 0. 887,P〈0. 05）. Conclusion：Hyperthyroidism may affect curative effect

关 键 词：甲状腺功能亢进 康复期 甲状旁腺激素 骨代谢 临床意义 

分 类 号：R581.1[医药卫生—内分泌]