甲亢患者骨代谢相关细胞因子及骨代谢指标的变化研究

[摘要] 目的 探讨甲亢患者骨代谢相关细胞因子及骨代谢指标的变化规律。 方法 选择2010年5月～2011年1月于本院进行治疗的64例甲亢患者为观察组，选择同期进行健康体检的64名人员为对照组。将两组患者的甲状腺激素、骨代谢相关细胞因子及骨代谢指标水平进行检测及比较。 结果 甲状腺相关激素：观察组游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、甲状腺旁素（PTH）水平均高于对照组，促甲状腺激素（TSH）水平低于对照组（P < 0.05）；骨代谢相关细胞因子：观察组白介素-6（IL-6）水平高于对照组，降钙素（CT）、肿瘤坏死因子（TNF）、胰岛素样生长因子-Ⅱ（IGF-Ⅱ）水平明显降低对照组（P < 0.05）；骨代谢指标：观察组钙离子（Ca2+）、碱性磷酸酶（AKP）、骨钙素（BGP）、Ⅰ型胶原吡啶交联终肽（ⅠCTP）及Ⅰ型原胶原氨基端前肽（PⅠNP）均高于对照组高，骨密度（BMD）低于对照组（P < 0.05）。 结论 甲亢患者可表现出骨代谢相关细胞因子及骨代谢指标的明显变化，在此类患者的治疗过程中对此方面也应给予足够的重视。

[关键词] 甲状腺功能亢进；甲状腺激素；骨代谢相关细胞因子；骨代谢

[中图分类号] R581.1 [文献标识码] A [文章编号] 1673-7210（2012）08（c）-0052-03

Study on the changes of bone metabolism related cytokines and bone metabolic indexes of patients with hyperthyroidism

WU Ping

Department of Endocrinology, Qianjiang Central Hospital of Chongqing City, Chongqing 409000, China

[Abstract] Objective To study varying pattern of bone metabolism related cytokines and bone metabolic indexes of patients with hyperthyroidism. Methods 64 cases of patients with hyperthyroidism in our hospital from May 2010 to January 2011 were selected as the observation group, at the same time 64 healthy personnel were selected as the control group. The thyroid hormone, bone metabolism related cytokines and bone metabolic indexes between the two groups were detected and compared. Results Thyroid related hormones: FT4, FT3 and PTH of the observation group were all higher than those of the control group; TSH was lower than that of the control group (P < 0.05). Bone metabolism related cytokines: IL-6 of the observation group was higher than that of the control group; CT, TNF and IGF-Ⅱ were all significantly lower than those of the control group (P < 0.05). Bone metabolic indexes: Ca2+, AKP, BGP, I CTP and P I NP of the observation group were all higher than those of the control group; BMD was lower than that of the control group (P < 0.05). Conclusion Changes of bone metabolism related cytokines and bone metabolic indexes of patients with hyperthyroidism are obvious, and it should be paid enough attention during treatment.

[Key words] Hyperthyroidism; Thyroid hormone; Bone metabolism related cytokines; Bone metabolic

甲状腺功能亢进（甲亢）在临床上主要归属于自身免疫性疾病，患者表现为机体代谢紊乱，同时血清中存在的抗甲状腺激素可刺激甲状腺细胞分泌过量的甲状腺激素[1]。另外，甲亢患者机体除表现出甲状腺的症状体征及甲状腺激素的变化外，较多其他因子也可随之波动，对其进行研究可以进一步为甲亢的诊断治疗提供依据[1-2]。以往较多研究认为，甲状腺激素与骨成熟、发育有关[3-5]。本文笔者就甲亢患者骨代谢相关细胞因子及骨代谢指标的变化规律进行研究，现将研究结果报道如下：

1 资料与方法

1.1 一般资料

选取2010年5月～2011年1月于本院进行治疗的64例甲亢患者为观察组，选择同期进行体检的64例健康者为对照组。观察组中，男31例，女33例；年龄14～57岁，平均（38.4±10.1）岁；病程15 d～28年，平均（12.0±1.4）年；其中，轻度18例，中度25例，重度21例。对照组中，男32例，女32例；年龄14～60岁，平均、（40.3±11.6）岁。两组患者在性别、年龄等方面比较，差异无统计学意义（P > 0.05），具有可比性。两组患者均未有肝、肾功能障碍，骨骼以及其他内分泌疾病史，同时无近期应用容易引发骨质疏松的激素类、维生素D及钙剂等药物的情况。