男性肝硬化患者钙调激素与性激素变化及其临床意义

探讨男性肝硬化患者钙调激素与性激素变化及其临床意义.男性肝硬化患者48例(按Child-Pugh分级分为A、B、C三组), 男性健康对照组43名, 均进行骨密度(BMD)测定, 用免疫放射法(IRMA)及放射免疫法(RIA)测定甲状旁腺激素(PTH)、降钙素(CT)、骨钙素(BGP)、雌二醇(E2)和睾酮(T), 生化检测肝功能、碱性磷酸酶(ALP)、骨性碱性磷酸酶(BLP)及血钙(Ca2 )、磷(P3 ).肝硬化患者与对照组比较血清PTH升高、CT降低、BGP大部分患者降低、E2上升、T降级、E2/T比值升高;血清ALP及BLP均上升,血Ca2 及血P3 均下降, 骨质疏松发病率增高,而且随着肝功能损害加重, 上述变化越显著.男性肝硬化患者钙调激素及性激素紊乱, 导致肝性骨病, 成人以骨质疏松为主, 并随病情发展而趋严重.

Changes in Calcium Regulating Hormone and Sex Hormone in Male Patients with Liver Cirrhosis and Their Clinical Significance

To explore the significance of the changes in calcium regulating hormone and sex hormone in male patients with liver cirrhosis, a prospective study was performed on 48 male patients with liver cirrhosis and 43 controls. The serum levels of parathyroid hormone(PTH), calcitonnin(CT), osteocacin (BGP), estradial(E 2) and testosterone (T) were determined by IRMA or RIA. Serum levels of calcium(Ca 2+ ),phosphorus(P 3+ ) and alkaline phosphatase(ALP) were determined, and bone mineral density(BMD) was measured in all patients and controls. Cirrhotic patients showed lower serum CT,BGP,Ca 2+ , P 3+ T, and BMD.The serum levels of PTH, E 2, ALP and BLP were increased significantly in the cirrhosis group.When the condition of cirrhosis deteriorated, above-mentioned changes became much more obvious.Significant disorders of calcium regulating hormone and sex hormone in end-stage cirrhotic patients resulted in osteoporosis.