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目的评价特发性甲状旁腺功能减退症(简称特发甲旁减)的骨密度(BMD)改变,探讨长期甲状旁腺激素(PTH)缺乏对骨量的影响。方法回顾性分析1996—2006年北京协和医院诊治的71例特发甲旁减患者的病历资料,测定患者腰椎及股骨近端BMD,比较患者与健康志愿者及治疗时间<1年与治疗时间≥1年患者的BMD。结果特发甲旁减患者腰椎和股骨近端BMD均显著增高(P<0.01),各部位BMD均值较健康志愿者增加14.2%～31.9%。治疗时间<1年和治疗时间≥1年患者BMD比较差异无统计学意义(P>0.05)。结论特发甲旁减患者腰椎和髋部BMD值均显著增加,未发现钙剂和维生素D制剂治疗对其有显著影响,患者BMD增高的原因主要为PTH不足。
Objective To evaluate the changes of bone mineral density (BMD) in idiopathic hypoparathyroidism (idiopathic hypoparathyroidism) and to explore the effect of long-term parathyroid hormone (PTH) deficiency on bone mass. Methods The clinical data of 71 patients with idiopathic parathyroidectomy treated by Peking Union Medical College Hospital from 1996 to 2006 were retrospectively analyzed. The BMD of the lumbar and proximal femur of the patients were measured. The patients with healthy volunteers were compared with the treatment time <1 year and the treatment time ≥ 1 year patient’s BMD. Results The BMD of lumbar vertebra and proximal femur of patients with idiopathic hypothyroidism were significantly increased (P <0.01). The average BMD of each part increased 14.2% ~ 31.9% compared with healthy volunteers. There was no significant difference in BMD between treatment time <1 year and treatment time> 1 year (P> 0.05). Conclusions BMD of lumbar spine and hip are significantly increased in patients with idiopathic parathyroidectomy. There was no significant effect of calcium and vitamin D treatment on patients with BMD. The main cause of increased BMD was PTH deficiency.