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目的:探讨乙肝后肝硬化病人发生肝性骨病的原因。方法:测定51例病人血清钙、碱性磷酸酶、甲状旁腺激素、白蛋白的变化,并观察其中22例有明显抽搐症状的低钙血症病人对10％葡萄糖酸钙与维生素D_3的治疗反应。结果:51例病人中低钙血症、低蛋白血症者分别为42例(82.4％)、35例(68.6％);血清碱性磷酸酶高于正常两倍,甲状旁腺激素升高者分别为28例(54.9％)、19例(37.3％)。22例有明显抽搐症状的低钙血症病人对10％葡萄糖酸钙及维生素D_3治疗反应良好。结论:乙肝后肝硬化病人肝性骨病的发生与肝硬化所致的脂溶性维生素和钙吸收障碍、钙相关调节激素代谢紊乱及低蛋白血症关系密切。
Objective: To investigate the cause of hepatic osteodystrophy in patients with posthepatitic cirrhosis. Methods: The changes of serum calcium, alkaline phosphatase, parathyroid hormone and albumin in 51 patients were measured. The treatment of 10% calcium gluconate and vitamin D_3 in 22 hypocalcemic patients with obvious tics was observed reaction. Results: Among the 51 patients, hypocalcemia and hypoalbuminemia were 42 (82.4%) and 35 (68.6%) respectively, serum alkaline phosphatase was twice as high, hyperparathyroid hormone They were 28 (54.9%) and 19 (37.3%) respectively. Twenty-two hypocalcemia patients with significant tics responded well to 10% calcium gluconate and vitamin D_3. Conclusion: The incidence of hepatic osteodystrophy in patients with posthepatitic cirrhosis is closely related to the fat-soluble vitamins and calcium absorption disorders caused by liver cirrhosis, the disturbance of calcium-related hormone metabolism and hypoproteinemia.