Graves病治疗前及治疗中血清游离钙与血,尿钙磷代谢异常

46例Graves病患者治疗前血清游离钙(Ca~( ))、磷(P)、碱性磷酸酶(AKP)及24小时尿钙(Ca)、P、羟脯氨酸(Hyp)排量水平都显著高于正常对照组。经治疗2—3个月甲亢病情控制后,血Ca~( )、P及24小时尿Ca、P亦随之恢复正常,但血AKP与24小时尿Hyp仍高于对照组。高钙血症比率在血Ca、校正钙与Ca~( )测定中分别为11.2％、16.3％与30.0％。前臂骨密度呈现骨量减少和腰椎相示骨质疏松者分别为29.0％和13.3％。本文对Graves病患者的钙、磷和骨代谢改变及其发生作了初步讨论。

SERUM FREE CALCIUM AND ABNORMAL METABOLISM OF SERUM AND URINE CALCIUM AND PHOSPHORUS IN GRAVES' DISEASE BEFORE AND DURING TREATMENT

The serum free, calcium(Ca )and some relevantindices of calcium (Ca) and phospherus(P)metabolism were measured in 46 oases of Graves'disease before and during the antithyroid treatment. The results showed that the levels of serum Ca , P and alkaline phosphatase (AKP) and 24-h urine Ca, P and hydroxyproline (Hyp) were very significantly greater in the untreated patients with Graves'disease than in the control group, but the values of serum Ca and 25-hydroxyvitamin D25(OH)D3] were not different from those of the control group. After 2-3 months'antithyroid treatment with the hy-perthyroid status controlled, the serum Ca and P and 24-h urine Ga and P decreased to normal range. However, the serum AKP and urinary Hyp were still greater than those of the control group. Our results excluded the possibility of elevation of serum Ca due to dehydration. The excess of thyroid hormone may be the main cause of hypercalcemia in Graves'disease. The rates of hypercalcemia of our patients in serum Ca, corrected Ca and Ca were 11.2%, 16.3% and 30.0% respectively. The descending in serum albumin may conceal the rate and the degree of hypercalcemia in Graves'disease. The bone mineral densities (BMD) of ulna and radius were very significantly lower in the patients wih Graves' disease than in the control group of the same age and sex. The BMD in 20% of the patients wih Graves' disease was lower than the normal value.