骨化三醇对男性酒精性肝硬化患者骨密度和骨代谢的影响

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (6): 691-694.

骨化三醇对男性酒精性肝硬化患者骨密度和骨代谢的影响

李东, 夏晨梅, 陈霞, 颜海帆, 冯崇炽

温岭市第一人民医院消化科, 温岭 317500, 浙江

收稿日期:2013-11-25 修回日期:2014-06-05 发布日期:2014-07-01
作者简介:李东, 男, 本科, 主治医师, 主要从事消化内科临床和科研工作。Tel: 13819668191 E-mail: lidongxm@126.com

Effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis

LI Dong, XIA Chen-mei, CHEN Xia, YAN Hai-fan, FENG Chong-zhi

Department of Gastroenterology, the First People's Hospital of Wenling, Wenling 317500, Zhejiang, China

Received:2013-11-25 Revised:2014-06-05 Published:2014-07-01

摘要/Abstract

摘要： 目的: 探讨补充骨化三醇对酒精性肝硬化患者骨密度和骨代谢指标的影响。方法: 将维生素D缺乏的酒精性肝硬化患者随机分成观察组和对照组, 两组常规治疗相同, 观察组给予骨化三醇胶丸(0.25 μg/d)治疗, 比较两组治疗半年后骨密度及β胶原特殊序列(β-CTx)、25-羟维生素D(25-OHD)、血钙、血磷、甲状旁腺激素(PTH)等骨代谢指标的差别。结果: 观察组治疗后血磷、PTH均较治疗前显著下降, 25-OHD、血钙均较治疗前显著上升, 差异均有统计学意义(P<0.05);对照组治疗后25-OHD较治疗前显著下降, 差异有统计学意义(P<0.05);治疗后, 观察组血钙和25-OHD显著高于对照组, 血磷和PTH显著低于对照组, 差异均有统计学意义(P<0.05);治疗后, 观察组和对照组骨密度、T值、β-CTx和肝功能比较, 差异无统计学意义(P＞0.05)。结论: 补充骨化三醇半年可改善酒精性肝硬化患者维生素缺乏状态, 但未发现能阻止骨破坏和提高骨密度。

关键词: 维生素D, 酒精性肝硬化, 骨密度, 骨代谢

Abstract: AIM : To explore the effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis.METHODS: 112 male patients with alcoholic cirrhosis were randomly divided into the observe group(n=56)and the control group(n=56). They all accepted the conventional treatment, but the patients in the observed group were given the treatment of calcitriol (0.25 μ g/d). The difference of the bone mineral density, beta-isomerized C-telopeptide(β-CTx), 25- hydroxy vitamin D (25-OHD), serum calcium, serum phosphorus and parathyroid hormone (PTH) were compared between the two group after 6 months treatment.RESULTS: The serum phosphorus and PTH in the observed group after treatment were significantly lower than that before treatment(P<0.05), and the 25-OHD and serum calcium in the observed group after treatment were significantly higher than that before treatment(P<0.05); the 25-OHD in the control group after treatment were significantly lower than that before treatment(P<0.05). After treatment, the serum calcium and the 25-OHD in the observation group were significantly higher than that in the control group(P<0.05), the serum phosphorus and PTH in the observation group were significantly lower than that in the control group(P<0.05). After treatment, there is no significant difference of bone mineral density, T score, β-CTx and liver function both in the observation group and in the control group(P＞0.05).CONCLUSION: Supplement of vitamin D for 6 months could improve vitamin deficiency in male patients with alcoholic cirrhosis, but can't stop the destruction of bone and increase bone mineral density.

Key words: vitamin D, alcoholic cirrhosis, bone mineral density, bone metabolism

中图分类号:

李东, 夏晨梅, 陈霞, 颜海帆, 冯崇炽. 骨化三醇对男性酒精性肝硬化患者骨密度和骨代谢的影响[J]. 中国临床药理学与治疗学, 2014, 19(6): 691-694.

LI Dong, XIA Chen-mei, CHEN Xia, YAN Hai-fan, FENG Chong-zhi. Effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 691-694.

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