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目的探讨131Ⅰ治疗甲状腺功能亢进(简称甲亢)对骨代谢的影响。方法58例甲亢患者治疗前、治疗后3及6个月分别检测其血清TT3、TT4、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治疗后6个月(除无效组外)与治疗前及治疗后各组与无效组的各部位平均BMD值比较差异有显著性(P<0.05);②甲亢131Ⅰ治疗后6个月BGP、CT、CT/PTH比值、ALP和Ca与治疗前及治疗后各组与无效组比较差异有显著性(P<0.01或P<0.05);③治疗前血清TT3水平与血清BGP呈正相关(r=0.4113,t=2.9896,P<0.005);血清Ca与TT3水平及CT/PTH比值呈正相关(r值分别为0.3613和0.3915,t值分别为2.6836和2.9639,P<0.01和<0.005)。结论131Ⅰ治疗甲亢患者能使其骨代谢指标在短时间里有较好恢复。
Objective To investigate the effect of 131 Ⅰ treatment on hyperthyroidism (hyperthyroidism) on bone metabolism. Methods Serum levels of TT3, TT4, sTSH, BGP, PTH and CT were measured in 58 hyperthyroid patients before treatment, 3 and 6 months after treatment. The contents of ALP, Ca and P were measured by automatic biochemical analyzer. Before and after treatment, the bone of forearm, lumbar spine (L2-L4) and upper femur Density (BMD) values. Results ① The average BMD of each site of hyperthyroidism 131 Ⅰ after 6 months (except invalid group) and before and after treatment were significantly different (P <0.05); ② After 131 Ⅰ treatment of hyperthyroidism, 6 The BGP, CT, CT / PTH ratio, ALP and Ca in different groups were significantly different from those before treatment and after treatment (P <0.01 or P <0.05); ③TT level before treatment was positively correlated with serum BGP (r = 0.4113, t = 2.9896, P <0.005). Serum Ca was positively correlated with TT3 level and CT / PTH ratio (r = 0.3613 and 0.3915, t = 2.6836 and 2.9639, P <0.01 and <0.005, respectively) . Conclusion 131 Ⅰ treatment of patients with hyperthyroidism can make its bone metabolism indicators better recovery in a short time.