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目的 :探讨左旋甲状腺素 (L -T4)治疗结节性甲状腺肿对骨代谢的影响。方法 :对 37例结节性甲状腺肿患者 ,在治疗前及治疗后 1年余 ,应用双能X线吸收法测定第 2～ 4腰椎 (L2～ 4 )和股骨颈、大转子、Ward三角骨密度 (BMD) ,采用ELISA法测定尿脱氧吡啶啉 (DPD) ,RIA法测定骨钙素 (BGP)等 ,以 34例健康者为对照。结果 :治疗前结节性甲状腺肿与健康组比较 ,DPD ,BGP ,BMD差异无显著意义 ,L -T4治疗后DPD和BGP升高 ,BMD下降 ,差异有显著意义 (P <0 0 5 )。结论 :L -T4治疗结节性甲状腺肿可导致骨转换加速并引起不同程度的骨量丢失
Objective: To investigate the effect of levothyroxine (L-T4) on nodular goiter on bone metabolism. Methods: Thirty-seven patients with nodular goiter were treated with dual energy X-ray absorptiometry before and after treatment for lumbar spine (L2-4), femoral neck, greater trochanter, Ward trochanter (BMD), urinary deoxypyridin (DPD) by ELISA, BGP by RIA and so on, 34 healthy controls were used as control. Results: There was no significant difference in DPD, BGP and BMD between nodular goiter and healthy group before treatment. DPD and BGP increased and BMD decreased after L-T4 treatment, the difference was significant (P <0.05). Conclusion: L-T4 treatment of nodular goiter can lead to accelerated bone turnover and cause different degrees of bone loss