论文部分内容阅读
目的 慢性严重肝脏损害常合并肝性骨病。为了探讨终末期肝病患者的钙调节激素变化和骨转换率状态 ,我们回顾性分析了 17例乙肝后肝硬化失代偿的男性患者 ,并和年龄、身高、体重相匹配的健康男性进行对照研究。方法 肝硬化组和对照组均检测其血清性激素 [雄激素 (T)、雌激素 (E2 ) ],钙调节激素 [甲状旁腺素 (PTH)、降钙素 (CT)和 2 5羟维生素D3(2 5 -OHVD3) ]和骨转换指标 [血清骨钙素 (BGP)和尿脱氧吡啶啉 肌酐比值 (Dpd Cr) ]以及钙 (Ca2 + )、磷 (PO3- )和碱性磷酸酶 (ALP)。结果 显示与对照组相比 ,肝硬化组血清T明显降低、E2 水平和E2 T比值显著升高 ;血清PTH显著升高、2 5 -OHVD3明显降低 ,而CT差异不大。其中E2 升高和 2 5 -OHVD3降低有极显著意义。肝硬化组血清BGP和Ca2 + 水平明显降低、尿Dpd Cr比值和尿Ca2 + Cr比值明显升高。而血清CT和PO3- 差异不大。结论 我们认为慢性严重肝硬化患者骨量减低 ,呈现出骨形成降低、骨吸收增强之特征 ,与维生素D和性激素代谢异常有关 ,而PTH升高乃继发性改变
Purpose Chronic severe liver damage is often associated with hepatic osteodystrophy. To investigate calcium-regulated hormonal changes and bone turnover rates in patients with end-stage liver disease, we retrospectively analyzed 17 males with decompensated cirrhosis of the liver and compared them to healthy men with age, height, and weight . Methods The levels of serum sex hormones (T and E2), calcium-regulated hormones (PTH), calcitonin (CT) and 25 hydroxyvitamin D3 (2 5 -OHVD3) and bone turnover (BGP and Dpd Cr) and calcium (Ca2 +), phosphate (P03-) and alkaline phosphatase ). The results showed that compared with the control group, serum T significantly decreased, E2 level and E2 T ratio increased significantly in serum of patients with liver cirrhosis; serum PTH increased significantly, 25-OHVD3 decreased significantly, while CT showed no significant difference. Among them, the increase of E2 and the decrease of 25-OHVD3 have very significant significance. Serum levels of BGP and Ca2 + were significantly decreased in cirrhotic patients, and urinary Dpd Cr ratio and urinary Ca2 + Cr ratio were significantly increased. Serum CT and PO3- little difference. Conclusions We suggest that patients with chronic severe liver cirrhosis have decreased bone mass with reduced bone formation and enhanced bone resorption, which is associated with abnormal metabolism of vitamin D and sex hormones, whereas elevated PTH is a secondary change