本文關(guān)鍵詞： Graves病 25-羥維生素D3 PTH PINP S-CTX　出處：《蚌埠醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討Graves病(Graves disease,GD)患者維生素D營養(yǎng)狀態(tài)及其與骨代謝指標(biāo)血清I型原膠原N-端前肽(procollagen type I N-terminal peptide,PINP)和I型膠原交聯(lián)C-末端肽(C-telpeptide of type I collagen,S-CTX)水平的相關(guān)性。方法選取初診或復(fù)發(fā)的GD患者178例,其中男74例,女104例,用放射免疫分析方法(Radioimmunoassay,RIA)測定所有受試者血清25-羥維生素D3[25-(OH)D3]、促甲狀腺激素受體抗體(Thyrotropin receptor antibodies,TRAb);用酶聯(lián)免疫吸附法(Enzyme-linked immunoassay,ELISA)測定血清PINP、S-CTX;采用自動生化分析儀檢測血清鈣(Calcium,Ca)、磷(Phosphorus,P);用電化學(xué)發(fā)光法檢測血清三碘甲狀原氨酸(Triiodothyronine,TT3)、甲狀腺激素(Thyroxine,TT4)、促甲狀腺激素(Thyroid stimulating hormore,TSH),甲狀旁腺激素(Parathyroid hormore,PTH)。根據(jù)血清25-(OH)D3水平進行分組,比較各組間各項指標(biāo)的差異。結(jié)果(1)178名GD患者中,維生素D水平缺乏、不足和充足者的比例分別為24.16%、29.21%、46.63%。(2)25-(OH)D312ng/ml組的血清PINP、S-CTX高于25-(OH)D312-20ng/ml組25-(OH)D320-30ng/ml組、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D312-20ng/ml組的血清PINP、S-CTX高于25-(OH)D320-30ng/ml組(P0.05)、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D320-30ng/ml組的血清PINP、S-CTX高于25-(OH)D3≥30ng/ml組(P0.05)。(3)25-(OH)D312ng/ml組的血清TT3、TT4高于25-(OH)D312-20ng/ml組、25-(OH)D320-30ng/ml組、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D312-20ng/ml組的血清TT3、TT4高于25-(OH)D320-30ng/ml組(P0.05)、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D320-30ng/ml組的血清TT3、TT4高于25-(OH)D3≥30ng/ml組(P0.05)。各組間血清TSH、TRAb差異無統(tǒng)計學(xué)意義(P0.05)。(4)25-(OH)D312ng/ml組的血清PTH、Ca高于25-(OH)D312-20ng/ml組(P0.05)、25-(OH)D320-30ng/ml組(P0.01)、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D312-20ng/ml組的血清PTH、Ca高于25-(OH)D320-30ng/ml組(P0.05)、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D320-30ng/ml組的血清PTH、Ca高于25-(OH)D3≥30ng/ml組(P0.05)。25-(OH)D312ng/ml組的血清P低25-(OH)D312-20ng/ml組、25-(OH)D320-30ng/ml組、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D312-20ng/ml組的血清P低于25-(OH)D320-30ng/ml組(P0.05)、25-(OH)D3≥30ng/ml組(P0.01),25-(OH)D320-30ng/ml組的血清P低于25-(OH)D3≥30ng/ml組(P0.05)。(5)Pearson相關(guān)分析顯示25-(OH)D3與PINP、S-CTX、PTH、TT3、TT4、Ca呈負(fù)相關(guān)(P0.01),與P呈正相關(guān)(P0.01),與年齡、病程、TSH、TRAb均無明顯相關(guān)性(P0.05);PINP、CTX分別與PTH、TT3、TT4、Ca呈正相關(guān)(P0.01),與25-(OH)D3、P呈負(fù)相關(guān)(P0.01),與年齡、病程、TSH、TRAb均無明顯相關(guān)性(P0.05)。結(jié)論1、GD患者大多數(shù)存在維生素D的缺乏和不足;2、在GD患者中,維生素D水平與PINP、S-CTX呈負(fù)相關(guān),可能提示隨著維生素D的減少,骨形成、骨吸收增強,且骨吸收作用增強大于骨形成;3、GD患者血清維生素D水平與TT3、TT4水平呈負(fù)相關(guān)。與TSH、TRAb無相關(guān)性。
[Abstract]:Objective to investigate the effect of Graves disease (Graves disease, GD) the nutritional status of patients with vitamin D and bone metabolism index of serum type I procollagen terminal propeptide (procollagen type N- I N-terminal peptide, PINP) and type I collagen crosslinked C- terminal peptide (C-telpeptide of type I collagen, S-CTX). The relationship between the level of 178 patients with GD methods newly diagnosed or recurrent cases, 74 cases were male, 104 were female, radioimmunoassay (Radioimmunoassay, RIA) of all subjects were measured serum 25- hydroxyvitamin D3[25- D3] (OH), thyroid stimulating hormone receptor antibody (Thyrotropin receptor, antibodies, TRAb); enzyme linked immunosorbent assay (Enzyme-linked immunoassay, ELISA determination of serum PINP, S-CTX); the serum calcium was detected by automatic biochemical analyzer (Calcium, Ca), P (Phosphorus, P); three iodine thyroid original acid by chemiluminescence detection of blood (Triiodothyronine, TT3, thyroid hormone (Thyro) xine,TT4),淇冪敳鐘惰吅嬋，

本文編號：1554806