肝炎肝硬化的骨钙素、甲状旁腺素、降钙素的变化及其临床意义

目的：为了解肝硬化骨病的形成机理。方法：本文采用放射免疫法对３５例肝炎肝硬化的血清进行了骨钙素、甲状旁腺素（ＰＴＨ）及降钙素（Ｃａｌｃｉｔｏｎｉｎ）的测定。结果：肝硬化患者的骨钙素（Ｇａｌ）明显高于正常对照（Ｐ＜０．０１），ＰＴＨ也高于正常，血钙低于正常，但均无统计学意义（Ｐ＜０．０５），各激素与血清白蛋白、凝血酶原时间及总胆红素之间无明显相关。按Ｃｈｉｌｄ分级，Ｃ级患者的Ｇａｌ及ＰＴＨ明显高于Ａ级及Ｂ级患者，而血钙浓度低于Ａ级及Ｂ级。结论：肝硬化对骨病的产生与所测三种激素的代谢紊乱有密切关系，由于钙离子吸收不良所致的低钙血症在致肝硬化骨病中可能起着相当重要的作用

Determination of osteocalcin,parathyroid hormone.calcitonin in cirrhosis and its clinical significance

Aim: In order to understand the mechanism that can account for osteopenia in liver cirrhosis, Thirty five patients with liver cirrhosis were studied.Methods: Osteocalcin (Gal),parathyroid Hormone (PTH) Calcitonin were determined in serum of patients with liver cirrhosis by radio-immunoassay. Result:In 35 cirrhosis, mean concentration of Gal was significantly increased compared to normal controls (P<0.01),mean concentration of PTH was higher and that of serum calcium was lower than normal controls,but significant differcnce was not reached. No correlation was found between every hormone measured and serum albumin, prothrombin time and total bilirrubin. Gal level and PTH level in patients with C grade of child classification were significantly higher than that in patients with A and B grade. Concentration of serum calcium in C grade was significantly reduced compared with A and B grade.Conclusion: These data suggested that development of osteopenia in cirrhosis was closely associated with metabolic disturbance of every measured hormone. Hypocalcemia possibly caused by malabsorption of calcium maybe play an important role in leading to osteopenia in liver cirrhosis.