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目的 :探讨 1,2 5 (OH) 2 D3、PTH对慢性肝病患者骨代谢的影响。方法 :采用竞争性放射受体等方法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 1,2 5 (OH) 2 D3、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 1,2 5 (OH) 2 D3、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。 1,2 5 (OH) 2 D3 水平与BGP、BMD呈显著正相关 ;PTH与血钙、BMD无相关性。结论 :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 1,2 5 (OH) 2 D3 减少为关键因素 ,并可作为反映肝病程度的一项敏感指标 ,而PTH升高对肝病骨代谢无重要影响
Objective: To investigate the effects of 1,25 (OH) 2 D3, PTH on bone metabolism in patients with chronic liver disease. Methods: The levels of serum 1,25 (OH) 2 D3, BGP, parathyroid hormone (PTH) and serum parathyroid hormone in patients with chronic hepatitis B (CHB) and cirrhosis were detected by competitive radio- (PTH), calcium, phosphorus and ulnar radius average density (BMD), and compared with the control group. Results: Serum 1,25 (OH) 2 D3, BGP and BMD decreased significantly in both groups, especially in cirrhosis group. Serum PTH increased significantly in cirrhosis group. Serum calcium decreased significantly in both groups, but there was no difference between the three groups. The level of 1,25 (OH) 2 D3 had a significant positive correlation with BGP and BMD. There was no correlation between PTH and serum calcium and BMD. CONCLUSIONS: There are disorders of bone metabolism that mainly reduce the bone formation in patients with chronic liver disease. The decrease of serum 1,25 (OH) 2 D3 is the key factor and can be used as a sensitive index to reflect the degree of liver disease, while the increase of PTH Liver disease has no important effect on bone metabolism