甲状腺功能亢进症患者血清甲状腺激素、钙磷水平与骨质疏松的相关性  

Changes in serum levels of thyroid hormones, calcium, and phosphorus and their correlation with osteoporosis in patients with hyperthyroidism

作　　者：康静 刘宇光 王冲[1] 吴耀辉 朱昕[1] 程霖[1] Kang Jing;Liu Yuguang;Wang Chong;Wu Yaohui;Zhu Xin;Cheng Lin(Department of Endocrinology,Heze Municipal Hospital,Heze 274000,China)

机构地区：[1]菏泽市立医院内分泌科,274000

出　　处：《国际医药卫生导报》2018年第22期3445-3448,共4页International Medicine and Health Guidance News

摘　　要：目的探讨甲状腺功能亢进症（甲亢）患者血清甲状腺激素、钙磷水平变化及其与骨质疏松的相关性.方法选取2016年6月至2018年5月本院收治的120例甲状腺功能亢进症男性患者（甲亢组）和同期在本院体检30例健康男性志愿者（对照组）为研究对象,检测血清甲状腺激素[游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）]、钙（Ca2＋）、磷（P3＋）、碱性磷酸酶（ALP）水平及骨密度,将甲亢组按照骨密度（BMD）分为骨质疏松组（n=45）、骨量减低组（n=35）、骨量正常组（n=40）,并进行相关性分析.结果与对照组相比,甲亢组Ca2＋、P3＋、ALP明显高,差异有统计学意义（均P 〈0.01）;甲亢患者中,Ca2＋、P3＋、ALP、FT3、FT4水平,骨质疏松组〉骨量减低组〉骨量正常组;TSH水平,骨质疏松组〈骨量减低组〈骨量正常组,且差异均有统计学意义（均P〈0.01）.Ca2＋、P3＋、ALP、FT3、FT4与腰椎、股骨颈BMD呈明显负相关（r=-0.351、-0.308、-0.325、-0.416、-0.426,均P 〈0.01）,TSH与腰椎股骨颈BMD有正相关（r=0.258,P 〈0.01）.结论甲亢患者血清甲状腺激素和钙磷、ALP水平变化在其骨质疏松预测中有重要临床意义,临床可据此为患者实施合理防治措施,以降低甲亢引起的骨质疏松的风险.Objective To investigate the changes in serum levels of thyroid hormones, calcium, and phosphorus and their correlation with osteoporosis in patients with hyperthyroidism. Methods 120 male patients with hyperthyroidism （the hyperthyroidism group） treated at our hospital from June, 2016 to May, 2018 and 30 healthy male volunteers （the control group） who received physical examination at our hospital during the same period were selected as test objects. Their serum thyroid hormones [Free triiodothyronine （FT3）, free thyroxine （FT4）, thyrotropin （TSH）], calcium （Ca2＋）, phosphorus （P3＋）, alkaline phosphatase （ALP） levels, and bone density were detected. The hyperthyroidism group was divided into an osteoporosis group （n=45）, a bone mass reduction group （n=35）, and a normal bone mass group （n=40） according to the bone mineral density （BMD）. And correlation analysis was done. Results The levels of Ca2＋, P3＋, ALP, FT3, and FT4 were signifcantly higher andthe level of TSH was signifcantly lower in the hyperthyroidism group than in the control group （all P 〈 0.01）. The levels of Ca2＋, P3＋, ALP, FT3, and FT4 were signifcantly higher and the level of TSH was signifcantly lower in the osteoporosis group than in the osteopenia group or the normal bone mass group （P 〈 0.01）. There were significant differences in the above indicators between the osteopenia group and the normal bone mass group （all P〈0.01）. Ca2＋, P3＋, ALP, FT3 and FT4 obviously negatively correlated with the BMD of lumbar spine and femoral neck （r=-0.351, -0.308, -0.325, -0.416, -0.426, all P 〈 0.01）; while TSH positively correlated with the BMD of lumbar spine and femoral neck （r=0.258, P 〈0.01）. Conclusions Changes in serum levels of thyroid hormones, calcium, phosphorus, and ALP in patients with hyperthyroidism are of important clinical signifcance in predicting osteoporosis. According to this, reasonable prevention and treatment can be carried out to reduce the r

关 键 词：甲状腺功能亢进 骨质疏松 甲状腺激素 钙磷水平 相关性 

分 类 号：R581.1[医药卫生—内分泌]