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[甲状腺功能亢进症患者药物治疗前后骨密度的评估]

[Evaluation of bone mineral density in hyperthyroid patients before and after medical therapy].

作者信息

Safi S, Hassikou H, Hadri L, Sbihi A, Kadiri A

机构信息

Service de Médecine Interne, Hôpital Militaire Moulay Ismaïl, BP S15, Meknès, Maroc.

出版信息

Ann Endocrinol (Paris). 2006 Mar;67(1):27-31. doi: 10.1016/s0003-4266(06)72536-7.

Abstract

Osteoporosis is a common complication of hyperthyroidism, but it is not often evaluated. The aim of this study is to examine bone mineral density (BMD) (dual energy X-ray absorptiometry: DEXA) in lumbar spine (L1-L4), femoral neck (FN) and Ward's triangle (TW) in 45 hyperthyroid patients (group A: n 25 active hyperthyroidism, group B: n 20 controlled hyperthyroidism on medical therapy, after a mean of 7 months of euthyroidism), compared to control group (group C: n 22). These 3 groups are adjusted by age, sex, menopausal status and BMI. In hyperthyroid patients (group A), as compared to the control group, we noticed a significant reduction of BMD (z score) in different sites, more markedly in the lumbar spine (p L1-L4: 0,005; p FN: 0,011; p TW: 0,019). In group A, no differences were found between BMD values after adjustment for Z score whatever the menopausal status (p L: 0.12; p FN: 0.33; p TW: 0.09) and degree ofhyperthyroidism (p L: 0.48; p FN: 0.41; p TW: 0.21). The degree of BMD in group B patients was different from that of patients in group A (p L: 0.37; p FN: 0.28; p TW: 0.31). and was significantly lower than in those of group C except for the TW (p L: 0.009; p CF: 0.038; p TW: 0.068). We conclude that it is important to consider that after reaching euthyroidism hyperthyroidism patients present a bone risk.

摘要

骨质疏松症是甲状腺功能亢进症的常见并发症,但对其评估并不常见。本研究旨在检测45例甲状腺功能亢进症患者(A组:25例活动性甲状腺功能亢进;B组:20例接受药物治疗且甲状腺功能得到控制,甲状腺功能正常平均7个月)腰椎(L1-L4)、股骨颈(FN)和沃德三角(TW)的骨密度(BMD)(双能X线吸收法:DEXA),并与对照组(C组:22例)进行比较。这3组在年龄、性别、绝经状态和体重指数方面进行了匹配。在甲状腺功能亢进症患者(A组)中,与对照组相比,我们发现不同部位的骨密度(z评分)显著降低,在腰椎更为明显(L1-L4:p=0.005;FN:p=0.011;TW:p=0.019)。在A组中,调整z评分后,无论绝经状态(L:p=0.12;FN:p=0.33;TW:p=0.09)和甲状腺功能亢进程度如何(L:p=0.48;FN:p=0.41;TW:p=0.21),骨密度值均无差异。B组患者的骨密度程度与A组患者不同(L:p=0.37;FN:p=0.28;TW:p=0.31),除TW外,显著低于C组(L:p=0.009;CF:p=0.038;TW:p=0.068)。我们得出结论,重要的是要认识到甲状腺功能亢进症患者甲状腺功能正常后仍存在骨风险。

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