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目的探讨甲状腺功能亢进症(Graves病)合并骨质疏松症(OP)患者骨吸收和骨形成指标变化及其与骨转换速率的关系。方法受试者分为4组:Graves病合并OP组(A组),Graves病无OP组(B组),非Graves病骨质疏松组(C组)和正常对照组(D组),各组间在性别、种族和体质指数等因素上均具有可比性;检测骨吸收指标:尿吡啶醚(PYD)和脱氧吡啶醚(DPD),股骨颈抗骨折能力(FS),同步观测骨形成指标:骨钙素(BGP),骨特异性碱性磷酸酶(骨AKP)。结果A组患者尿PYD和DPD含量明显高于C组(分别为P<0·01和P<0·05)和B组(均P<0·05),FS参数A组与C组比较(P<0·05)和B组比较差异有显著性(P<0·01)。而血清BGP和骨AKP在A,B,C3组之间差异无显著性;除FS外,所有指标参数A,B,C3组分别显著高于D组。结论Graves病并骨质疏松症患者骨吸收增多,大于骨形成减少,相对绝经后骨质疏松症是一种更高转换速率型骨质疏松。
Objective To investigate the changes of bone resorption and bone formation and its relationship with bone turnover rate in patients with hyperthyroidism (Graves’ disease) and osteoporosis (OP). Methods The subjects were divided into 4 groups: Graves’ disease combined with OP (group A), Graves’ disease without OP (group B), non-Graves’ disease (group C) and normal control group (group D) The indexes of bone resorption were PYD, DPD and FS, and the indexes of bone formation were observed simultaneously : Osteocalcin (BGP), bone-specific alkaline phosphatase (bone AKP). Results The urinary PYD and DPD contents in group A were significantly higher than those in group C (P <0.01 and P <0.05, respectively) and group B (all P <0.05) P <0 · 05) and group B, the difference was significant (P <0.01). However, there was no significant difference between serum BGP and bone AKP in group A, B and C3; except for FS, all the parameters A, B and C3 were significantly higher than those in group D, respectively. Conclusions The bone resorption in patients with Graves’ disease and osteoporosis increased more than that of bone formation, and osteoporosis was a higher conversion rate osteoporosis.