CAJ | 학술논문

背景:甲状腺功能亢进症及其导致的骨质疏松逐年增多.研究此时患者体内生长激素的变化情况,以便进一步认识其病理生理变化的机制.目的:了解甲亢合并骨质疏松患者血清生长激素水平的变化,以及甲状腺素水平、年龄、病程等相关因素对骨量丢失的影响.设计:病例分析.单位:河北省保定市第一中心医院内分泌科.对象:本研究在河北省保定市第一中心医院内分泌科完成.选择1999-10/2000-09本院门诊及住院的初诊甲亢患者146例.按骨密度(bone mineral density,BMD)分为BMD正常组44例,骨量减少组78例和骨质疏松组24例.方法:空腹采集肘静脉血,以同一批试剂测定生长激素(GH)、钙(Ca)、碱性磷酸酶(ALP)、甲状腺素T3(T3)及甲状腺素T4(T4)浓度.以直线相关分析法检验上述各变量间的相关性,并比较3组之间的差异.主要观察指标:①3组患者BMD测定结果的比较.②3组患者静脉血GH,Ca,ALP,T3,T4浓度的比较.结果:GH、ALP与BMD之间有非常显著负相关(r=-0.456,P＜0.001).GH与年龄,病程,T3,T4等指标之间无显著相关性(r=0.005～0.119,P＞0.10).Neck,Ward's,G.T.3部位的BMD与T3、T4及病程之间呈显著负相关[r=(-0.212)～(-0.165),P＜0.05],而L2-4的BMD与上述3指标无显著相关性(r=0.010～0.115,P＞0.10).结论:甲亢合并骨质疏松患者血清GH水平随着BMD的减少而升高.腰椎的BMD受T3,T4及甲亢病程的影响较小,而与年龄增长有密切关系.髋部的BMD减低比较明显,提醒甲亢患者预防髋部骨折.
배경:갑상선공능항진증급기도치적골질소송축년증다.연구차시환자체내생장격소적변화정황,이편진일보인식기병리생리변화적궤제.목적:료해갑항합병골질소송환자혈청생장격소수평적변화,이급갑상선소수평、년령、병정등상관인소대골량주실적영향.설계:병례분석.단위:하북성보정시제일중심의원내분비과.대상:본연구재하북성보정시제일중심의원내분비과완성.선택1999-10/2000-09본원문진급주원적초진갑항환자146례.안골밀도(bone mineral density,BMD)분위BMD정상조44례,골량감소조78례화골질소송조24례.방법:공복채집주정맥혈,이동일비시제측정생장격소(GH)、개(Ca)、감성린산매(ALP)、갑상선소T3(T3)급갑상선소T4(T4)농도.이직선상관분석법검험상술각변량간적상관성,병비교3조지간적차이.주요관찰지표:①3조환자BMD측정결과적비교.②3조환자정맥혈GH,Ca,ALP,T3,T4농도적비교.결과:GH、ALP여BMD지간유비상현저부상관(r=-0.456,P＜0.001).GH여년령,병정,T3,T4등지표지간무현저상관성(r=0.005～0.119,P＞0.10).Neck,Ward's,G.T.3부위적BMD여T3、T4급병정지간정현저부상관[r=(-0.212)～(-0.165),P＜0.05],이L2-4적BMD여상술3지표무현저상관성(r=0.010～0.115,P＞0.10).결론:갑항합병골질소송환자혈청GH수평수착BMD적감소이승고.요추적BMD수T3,T4급갑항병정적영향교소,이여년령증장유밀절관계.관부적BMD감저비교명현,제성갑항환자예방관부골절.
BACKGROUND: Hyperthyroidism and its induced osteoporosis gradually increase every year. To study the alteration of growth hormone in vivo at this period is good for the further understanding of the mechanism of its pathophysiological changes.OBJECTIVE: To comprehend the alteration of serous growth hormone in hyperthyroids with osteoporosis and the impacts of the correlative factors like thyroid level, age and the course of the disease on the loss of bone quantity.DESIGN: A case analysis. SSETTING: Department of Endocrinology, Boding First Central Hospital of Hebei Province.PARTICIPANTS: The study was performed in the Department of Endocrinology, Boding First Central Hospital of Hebei Province. Totally 146 hyperthyroids diagnosed for the first time were selected from the outpatient and inpatient departments of our hospital from Oetober 1999 to September 2000. According to their bone mineral density(BMD), the hyperthyroids were divided into normal group( n = 44), low-BMD group( n = 78) and osteoporosis group( n=24) based on bone mineral density(BMD).INTERVENTIONS: Pasting venous blood was collected from elbow vein for the detection of concentrations of growth hormone(GH), calcium(Ca), alkaline phosphatase (ALP), triiodothyronine (T3) and tetraiodothyronine ( T4 )with the reagent of the same batch. The eonelation among the above variants was analyzed by linear correlation analysis and the differences among the three groups were compared as well.among the three groups.RESULTS: There were very significant negative correlations among GH, ALP and BMD( r = -0. 456, P ＜ 0. 001) . GH had no significant correlations with age, course of disease, T3 and T4( r = 0. 005 to 0. 119, P ＞ 0. 10) .BMD of the neck, ward' s and G. T. parts were significantly negatively correlated with T3, T4 and the course of disease ( r = - 0.212 to - 0. 165 ) ( P＜ 0.05), while the BMD of L2 -4 was not correlated with the above three indices( r = 0. 010 to 0. 115, P ＞ 0. 10).CONCLUSION: The serous level of GH in hyperthyroids with osteoporosis elevates with the reduction of BMD. Lumbar BMD is relatively less affected by T3, T4 and the course of hyperthyroidism but closely related with the increase of age. The decrease of hipbone BMD is relatively obvious, which reminds the prevention of hipbone fracture in hyperthyroids.