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目的:通过研究结肠癌患者骨密度和有关骨矿物质生化指标的变化,探讨结肠癌骨质疏松症的发病机制。方法:应用双能X线吸收测定仪(DEXA)对45例结肠癌患者进行腰椎、股骨近端骨密度(BMD)测定,使用全自动生化仪器测定血清碱性磷酸酶(ALP)、血钙(Ca)、血磷(P)、血镁(Mg)、白蛋白(ALB)等生化指标,并与45例同年龄对照组比较。结果:结肠癌组的BMD值与对照组相比显著降低(P<0.01),Ca、P、Mg、ALB也显著降低(P<0.01或P<0.05),ALP无显著变化。行化疗患者与未行化疗患者相比,BMD值也显著降低(P<0.05),但Ca、P、Mg、ALP、ALB无显著变化。结论:结肠癌对患者骨代谢的影响为骨吸收增高,导致骨量丢失,引起骨质疏松症。原因可能与结肠癌患者营养物质代谢失衡、手术、年龄及化疗等因素有关。
OBJECTIVE: To investigate the pathogenesis of colon cancer with osteoporosis by studying the changes of bone mineral density and related biochemical indicators of bone mineral in patients with colon cancer. Methods: The bone mineral density (BMD) of the proximal femur in 45 patients with colon cancer was measured by dual energy X-ray absorptiometry (DEXA). The levels of serum alkaline phosphatase (ALP), serum calcium Ca, P, Mg and ALB were measured and compared with 45 controls of the same age group. Results: The BMD of colon cancer group was significantly lower than that of the control group (P <0.01), while the levels of Ca, P, Mg and ALB were also significantly decreased (P <0.01 or P <0.05). BMD was significantly lower in patients who underwent chemotherapy than those who did not receive chemotherapy (P <0.05), but there was no significant change in Ca, P, Mg, ALP and ALB. Conclusion: The effect of colon cancer on the bone metabolism in patients with increased bone resorption, resulting in loss of bone mass, causing osteoporosis. The reason may be related to the imbalance of nutrients in patients with colon cancer, surgery, age and chemotherapy and other factors.