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目的探讨131Ⅰ治疗甲状腺功能亢进(简称甲亢)前后骨代谢相关指标的变化。方法71例甲亢患者治疗前后2个月及4个月分别检测其血清总T3(TT3)、血清总T4(TT4)、高灵敏促甲状腺激素(sTSH)、骨钙素(BGP)、甲状旁腺素(PTH)和降钙素(CT)浓度,用全自动生化仪测定血清碱性磷酸酶(ALP)、血清钙(Ca)和无机磷(P)的含量,治疗前后均采用双能X线检测其前臂、腰椎(L2～L4)及股骨上段的骨密度(BMD)值。结果(1)甲亢131Ⅰ治疗4个月(除无效组外)与治疗前BMD值比较差异有显著性(P<0.05);(2)甲亢131Ⅰ治疗4个月BGP、CT、CT/PTH比值、ALP和Ca与治疗前比较差异有显著性(P<0.0l或P<0.05);(3)治疗前血清TT3水平与BGP呈正相关(r=0.3991,t=2.6989,P<0.005);血清Ca与血清TT3水平及CT/PTH比值呈正相关(r值分别为O.3136和0.3159,t值分别为2.1362和2.3693,P<0.01和P<0.005)。结论131Ⅰ治疗甲亢患者能使其骨代谢指标在短时间内有较好恢复。
Objective To investigate the changes of bone metabolism related indexes before and after 131 Ⅰ treatment of hyperthyroidism (referred to as hyperthyroidism). Methods Totally 71 patients with hyperthyroidism were tested for serum T3, TT4, sTSH, BGP and parathyroid glands 2 months and 4 months before and after treatment. (PTH) and calcitonin (CT) were measured. The levels of serum ALP, Ca and P were determined by automatic biochemical analyzer. Before and after treatment, The BMD of forearm, lumbar (L2 ~ L4) and upper femur were detected. Results (1) The BMD of hyperthyroidism patients with 131 Ⅰ treatment for 4 months (except invalid group) was significantly different from that before treatment (P <0.05). (2) The BGP, CT and CT / The serum levels of TT3 in serum before treatment were positively correlated with BGP (r = 0.3991, t = 2.6989, P <0.005) And serum TT3 levels and CT / PTH ratio was positively correlated (r values were O.3136 and 0.3159, t values were 2.1362 and 2.3693, P <0.01 and P <0.005). Conclusion 131 Ⅰ treatment of patients with hyperthyroidism can make its bone metabolism indicators better recovery in a short period of time.