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目的探讨甲状腺激素替代治疗前后甲减患者血清骨保护素(0PG),血清骨钙素(OCN)的变化。方法选择健康者15例和甲减患者30例,其中临床甲减(oHT)和亚临床甲减(sHT)各15例。所有甲减患者采用左旋甲状腺素(L-T4)补充治疗至甲状腺功能在正常范围内。血清0PG、OCN采用酶联免疫法测定。结果 L-T4治疗前oHT和sHT患者血清OPG水平分别为3.60±0.38ng/ml和3.51±0.32ng/ml,明显高于对照组(2.68±0.48ng/ml,P=0.000);血清OCN水平分别为3.36±0.87ng/ml和3.42±0.75ng/ml,明显低于对照组(4.79±0.87ng/ml,P=0.000);多元回归分析结果显示,oHT和sHT患者血清OPG均与TSH呈正相关(r=0.580,P=0.023;r=0.934,P=0.000),血清OCN均与TSH呈负相关(r=-0.964,P=0.000;r=-0.825,P=0.000)。治疗至甲状腺功能正常后,两组血清OPG水平明显降低(分别为2.77±0.37ng/ml和2.92±0.31ng/ml,P=0.000),接近对照组水平;血清OCN水平明显升高(分别为4.63±0.70ng/ml和4.62±0.70ng/ml,P=0.000),接近对照组水平。结论甲减患者L-T4治疗后骨代谢紊乱可能得到改善。
Objective To investigate the changes of serum osteoprotegerin (OPG) and serum osteocalcin (OCN) in patients with hypothyroidism before and after thyroid hormone replacement therapy. Methods Fifteen healthy subjects and 30 hypothyroidism patients were selected, including 15 patients with clinical hypothyroidism (oHT) and subclinical hypothyroidism (sHT). All patients with hypothyroidism using levothyroxine (L-T4) supplementation to thyroid function in the normal range. Serum 0PG, OCN by enzyme-linked immunosorbent assay. Results The levels of OPG in patients with oHT and sHT before L-T4 treatment were 3.60 ± 0.38ng / ml and 3.51 ± 0.32ng / ml respectively, which were significantly higher than those in control group (2.68 ± 0.48ng / ml, P = 0.000) (3.36 ± 0.87ng / ml and 3.42 ± 0.75ng / ml respectively), which were significantly lower than those in the control group (4.79 ± 0.87ng / ml, P = 0.000). Multiple regression analysis showed that serum OPG in oHT and sHT patients was positively correlated with TSH Serum OCN was negatively correlated with TSH (r = -0.964, P = 0.000; r = -0.825, P = 0.000). Serum levels of OPG were significantly decreased (2.77 ± 0.37 ng / ml and 2.92 ± 0.31 ng / ml, respectively, P = 0.000) after treatment to normal thyroid function, close to the control group; serum OCN levels were significantly increased 4.63 ± 0.70 ng / ml and 4.62 ± 0.70 ng / ml, P = 0.000), approaching the control group level. Conclusions Patients with hypothyroidism may be able to improve the disorder of bone metabolism after L-T4 treatment.