低血磷性佝偻病／骨软化症患者急性磷负荷对血磷和甲状旁腺激素水平的影响

目的比较低血磷性佝偻病／骨软化症（hypophosphatemic rickets／osteomalacia，HR／OM）患者与正常人磷负荷前后血磷（Pi）、甲状旁腺激素（iPTH）水平变化情况。方法14例HR／OM患者（低磷组）及8名健康志愿者（对照组）纳入本研究。对受试者行中性磷负荷试验，测定两组服磷前后血Pi、iPTH的水平。结果对照组服磷前血iFTH均处于正常水平；而低磷组中有7例正常，另7例高于正常。低磷组在磷负荷后30分钟至150分钟的血iPTH水平均显著高于基线水平（P〈0.05），而对照组仅在磷负荷后30分钟显著高于基线水平。结论HR／OM患者基础iPTH水平存在一定程度不均一性，其甲状旁腺对于磷负荷可能表现为“亢进”反应。

Acute effects of oral phosphate-salt loading on serum phosphate and parathyroid hormone in hypophosphatemic rickets/osteomalacia

Objective To compare the acute effets of oral phosphate-salt loading on parathyroid hormone （PTH） secretion in patients with hypophosphatemic rickets/osteomalacia （HR/OM） with that in normal individuals. Methods 14 patients with hypophosphatemic rickets/osteomalacia （hypophosphatemic group） and 8 healthy volunteers （control group） were enrolled in this study. Acute oral phosphate loading test was undertaken. Venous blood samples were drawn to determine serum Pi and iPTH levels. Results The baseline iPTH level was all in normal range in control group, while only in half of hypophosphatemic group was that normal, and that in another half of patients exceeded normal range. The serum iPTH levels in hypophosphatemic group were all significantly higher than baseline values （ P 〈 0. 05 ） from 30min to 150min after phosphate load, while those in control group were significantly above baseline value only at 30min after phosphate load. Conclusion There exists some degree of heterogenicity in the baseline serum iPTH levels in HR/OM patients. Parathyroid glands of HR/OM patients may present a kind of sensitive response to Pi loading.