24小时尿Crosslaps检测评价甲亢患者骨吸收的临床应用

目的:探讨24小时尿Crosslaps的测定对甲亢病人骨吸收评价的意义。方法:应用ELISA方法检测73例甲亢病人(观察组)和32名正常人(对照组)的24小时尿Crosslaps定量。结果:观察组24小时尿Crosslaps为(10.81±7.97)mg/24 h,高于对照组的(2.47±1.34)mg/24 h(P<0.01),并与血清甲状腺激素T4和FT3水平呈相关性(r=0.32,n=39;r=0.34,n=38;均P<0.05)。用他巴唑15～30mg/日治疗1个月后,患者24小时尿Crosslaps降低38.91％(n=28,P<0.01),但仍高于对照组。结论:24小时尿Crosslaps测定是甲亢病人骨吸收的敏感指标,可用于研究和监测甲亢病人骨转换。

The Assessment of Bone Resorption in Patients with Hyperthyroidism Using Twenty-four Hours Urinary Crosslaps

Objective: To study the significance of the level of 24 hours urinary Crosslaps on the assessment of bone turnover in patients with hyperthyroidism. Methods: Twenty-four hours urinary Crosslaps levels were measured with ELISA in 32 normal subjects and 73 patients with hyperthyroidism of Graves' disease before treatment. Results: Before the treatment, the mean concentration of 24 hours urinary Crosslaps (10.81 + 7.97)mg/24 h was much higher in the patients than in age-matched normal subjects (2.47 +1.34)mg/24 h,P<0.01. Twenty-four hours urinary Crosslaps was elevated above thenormal in most patients and was significantly correlated wth seurm T4 , free T3 concentration (r - 0.32,r - 0.34;P< 0.05; n = 39,38). After the treatment with methimazole (15-30 mg/day) ,24 hours urinary Crosslaps level was declined by 38.91% (n=28,P<0.01) in the patients, but did not return back to normal within 1 month. Conclusion: Twenty-four hours urinary Crosslaps concentration is a highly sensitive marker for the investigation of bone metabolism in patients with hyperthyroidism and can be used for the clinical investigation and therapeutic monitoring.