CAJ | 학술논문

目的：探讨分析绝经前后女性甲状腺功能亢进（甲亢）对骨密度的影响。方法选取2010年4月至2011年2月在湖北省妇幼保健院就诊的60例女性甲亢患者为研究对象，其中绝经期30例（甲亢A组），生育期30例（甲亢B组）；另选择同期体检的60例健康女性作为对照，其中绝经期30例（健康A组），生育期30例（健康 B组）。测定女性甲亢患者与健康者的骨密度，并进行比较。结果甲亢组患者游离三碘甲状腺原氨酸（ FT3）、游离四碘甲状腺原氨酸显著高于健康组（ P＜0．05），腰椎、股骨的骨密度显著低于健康组（P＜0．05）；线性回归分析结果显示：甲亢组患者的骨密度与绝经年限，病程，血清FT3水平呈负相关（P＜0．05），与血清促甲状腺激素（TSH）水平呈正相关（P＜0．05）；Logistic 回归分析结果显示：绝经年限、病程、FT3可能是导致女性甲亢患者并发骨质疏松的独立危险因素（P＜0．05），TSH是女性甲亢患者并发骨质疏松的独立保护因素（P＜0．05）。结论女性甲亢患者的骨密度显著低于正常的健康女性，尤其是绝经后患者更明显，故对绝境后女性甲亢患者治疗过程中需要注意骨质疏松的发生。
목적：탐토분석절경전후녀성갑상선공능항진（갑항）대골밀도적영향。방법선취2010년4월지2011년2월재호북성부유보건원취진적60례녀성갑항환자위연구대상，기중절경기30례（갑항A조），생육기30례（갑항B조）；령선택동기체검적60례건강녀성작위대조，기중절경기30례（건강A조），생육기30례（건강 B조）。측정녀성갑항환자여건강자적골밀도，병진행비교。결과갑항조환자유리삼전갑상선원안산（ FT3）、유리사전갑상선원안산현저고우건강조（ P＜0．05），요추、고골적골밀도현저저우건강조（P＜0．05）；선성회귀분석결과현시：갑항조환자적골밀도여절경년한，병정，혈청FT3수평정부상관（P＜0．05），여혈청촉갑상선격소（TSH）수평정정상관（P＜0．05）；Logistic 회귀분석결과현시：절경년한、병정、FT3가능시도치녀성갑항환자병발골질소송적독립위험인소（P＜0．05），TSH시녀성갑항환자병발골질소송적독립보호인소（P＜0．05）。결론녀성갑항환자적골밀도현저저우정상적건강녀성，우기시절경후환자경명현，고대절경후녀성갑항환자치료과정중수요주의골질소송적발생。
Objective To study on the impact of hyperthyroidism on bone mineral density in patients before and after menopause.Methods A total of 60 cases of female patients with hyperthyroidism admitted in Hubei Provincial Maternal and Child Health Hospital from Apr .2010 to Feb.2011 were selected as the hyperthyroidismgroup,including 30 cases of postmenopausal women(hyperthyroidism group A),and 30 cases of women at reproductive age ( hyperthyroidism group B );another 60 healthy women underwent physical examination in the hospital during the same period were selected as the control group ,including 30 cases of postmenopausal women(healthy group A),and 30 cases of women at reproductive age(healthy group B).The bone mineral density was tested among the patients with hyperthyroidism and the healthy females .Results In the hyperthyroidism group,levels of free triiodothyronine (FT3),free tetraiodothyronine(FT4) were signif-icantly higher than the healthy group(P<0.05), bone mineral density of lumbar and femur was significantly lower than the healthy group(P<0.05).Results of linear regression analysis showed that bone mineral den-sity of patients with hyperthyroidism had negative correlation with menopausal years ,course of disease,serum FT3 level(P<0.05),and had positive correlation with serum thyroid-stimulating hormone(TSH) level(P<0.05);results of multivariate logistic analysis showed that menopausal years,course of disease,FT3 may be the independent risk factors of osteoporosis in female patients with hyperthyroidism(P<0.05),and TSH is the independent protective factor of osteoporosis in female patients with hyperthyroidism(P<0.05).Conclu-sion The bone mineral density of patients with hyperthyroidism was obviously lower than the healthy fe-males,especially lower in women after menopause.Therefore,treatment for patients with hyperthyroidism after menopause needs to prevent the occurrence of osteoporosis.