慢性肝病患者血清VitD3水平与骨代谢的关系

检测了部分慢性乙型肝炎（下简称慢乙肝）及肝硬化患者的血清1，25（OH）2D3，骨钙素（BGP），甲状旁腺素（PTH），钙，磷及尺桡平均密度（BMD），并与对照组比较，结果两组患者血清1，25（OH）2D3，BGP及BMD值均明显下降，肝硬化组下降尤为显著，肝硬化组血清PTH显著升高，两组患者血钙明显降低，而血磷三组间无差异，1，5（OH）2D3水平与BGP，BMD呈显著正相关；PTH与血钙，BMD无相关性。提示慢性肝病患者存在以骨形成减少为主的骨代谢紊乱，其中血清1，25（OH）2D3减少为关键因素，PTH虽升高，但与肝病患者骨密度变化无相关。

Effects of serum 1,25(OH)_2D_3 on bone metabolism in patients with chronic liver diseases

Serum 1,25(OH) 2D 3, osteocalcin, parathyrin, calcium, phosphorus, mean bone density of ulna and radius(BMD) were examined in 64 patients with chronic hepatitis B and liver cirrhosis compared with healthy controls. It was found that serum 1,25(OH) 2D 3, osteocalcin levels and BMD decreased significantly in the patients, especially those with liver cirrhosis. Serum parathyrin levels increased greatly in liver cirrhosis. Serum calcium levels in the patients were much lower than in the controls. There was no significant difference in serum phosphorus levels between the patients and the controls. Positive correlation among 1,25(OH) 2D 3, osteocalcin and BMD was found. Among serum parathyrin, calcium and BMD there was no correlation. It is concluded that abnormal bone formation plays a main role in hepatic bone diseases. Low serum 1,25(OH) 2D 3 level is the key factor leading to hepatic bone disease. Hypocalcemia also plays an important role in hepatic bone disease. Elevated serum parathyrin has little effect on hepatic bone disease.