甲状腺功能亢进症患者抗甲状腺药物治疗1个月血钙、甲状旁腺素、碱性磷酸酶的变化  

Effect of one-month antithyroid drug on serum calcium,parathyroid hormone and alkaline phosphatase levels in patients with Graves' disease

作　　者：王转锁[1] 王新军[1] WANG Zhuansuo;WANG Xinjun(Department of Endocrinology,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院内分泌科,海口570102

出　　处：《实用医学杂志》2018年第18期3047-3050,共4页The Journal of Practical Medicine

基　　金：海南省自然科学基金(编号:20168306)

摘　　要：目的观察Graves病患者抗甲状腺药物治疗前及治疗1个月后血钙、甲状旁腺素、碱性磷酸酶的变化,探讨骨代谢与甲状腺功能的关系。方法收集36例初诊Graves病患者,抗甲状腺药物治疗前及治疗1个月后采集空腹静脉血,化学发光法测定血清甲状旁腺素(PTH)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4),生化法测定血钙、磷、碱性磷酸酶(ALP)、肝功能,以55例正常人群为对照。结果与对照组相比,Graves病组抗甲状腺药物治疗前血钙、ALP水平升高,血PTH降低,差异均有统计学意义。与抗甲状腺药物治疗前相比,Graves病患者抗甲状腺药物治疗1个月后血钙降低,血PTH、ALP水平升高,差异均有统计学意义。结论初诊Graves病患者骨转换增强,骨吸收/骨形成比增加。抗甲状腺药物治疗1月后骨吸收增强明显改善,骨形成增强持续,有利于骨重塑。Objective To investigate the changes of serum calcium,parathyroid hormone and alkaline phosphatase levels in patients with Graves’disease before and after one-month antithyroid drug and to investigate the relation between bone turnover and thyroid function.Methods Thirty-six newly diagnosed patients with Graves’disease were enrolled into the Graves’disease group and 55 healthy individuals as a control group.Fasting venous blood samples were collected before and after one-month antithyroid drug treatment in patients with Graves’disease.The levels of serum parathyroid hormone(PTH),free triiodothyronine(FT3)and free thyroxine(FT4)with thyroid-stimulating hormone(TSH)were measured by chemiluminescence method.Serum calcium,phospho-rus,alkaline phosphatase(ALP)levels and liver function were measured with biochemistry methods.Results Se-rum calcium and ALP levels were significantly higher;meanwhile,serum PTH was significantly lower in the Graves’disease group before antithyroid drug treatment compared with those in the control group.After one-month antithyroid drug treatment,serum calcium level was significantly decreased;meanwhile,serum PTH and ALP lev-els were significantly increased.Conclusion Newly diagnosed patients with Graves’disease are characterized by the accelerated bone turnover that increases the ratio of bone resorption to formation.After one-month antithyroid drug treatment,accelerated bone resorption is significantly improved,however,increased osteoblastic activity fol-lows;this is useful for bone remodeling.

关 键 词：GRAVES病 钙 甲状旁腺素 碱性磷酸酶 

分 类 号：R581.1[医药卫生—内分泌]