Chapuy M C, Meunier P, Terrier M, David L, Vignon G
Pathol Biol (Paris). 1975 May;23(5):349-59.
In ten patients with Paget's disease of bone (Group I) intramuscular injection of 50 MRC units of synthetic Salmon calcitonin (SCT) induced a marked decrease of serum calcium (-1,444 mg%), serum phosphorus (-1,06 mg%), urinary total hydroxyproline (-71%), and a marked increase of urinary cyclic AMP (+ 114%). These changes occur at maximum 6 hours after the injection with a return to the initial values after 24 hours. In six other patients with Paget's disease (Group II) the acute biological effects were of the same nature and magnitude after the injection of 100 MRC units of SCT. In this group a significant but temporary increase of the plasma parathyroid hormone level was demonstrated. The magnitude of the hypocalcemia seems proportional to the initial serum alkaline phosphatase and urinary hydroxyproline levels. After one month of treatment, the alkaline phosphatase and urinary hydroxyproline have more marked and more regular decrease in group II who received 100 MRC units of SCT daily than in group I who received 50 MRC units three times a week. The cellular mechanisms of these biological changes are discussed. A posology of two daily injections of 50 MRC units of SCT is suggested when a quick and maximum stoppage of pagetic remodeling is required.
在10例骨Paget病患者(第一组)中,肌肉注射50 MRC单位的合成鲑鱼降钙素(SCT)可使血清钙显著降低(-1.444mg%)、血清磷显著降低(-1.06mg%)、尿总羟脯氨酸显著降低(-71%),并使尿环磷腺苷显著增加(+114%)。这些变化在注射后最多6小时出现,24小时后恢复至初始值。在另外6例Paget病患者(第二组)中,注射100 MRC单位的SCT后,急性生物学效应在性质和程度上相同。在该组中,血浆甲状旁腺激素水平出现显著但短暂的升高。低钙血症的程度似乎与初始血清碱性磷酸酶和尿羟脯氨酸水平成正比。治疗1个月后,每日接受100 MRC单位SCT的第二组患者的碱性磷酸酶和尿羟脯氨酸的降低比每周三次接受50 MRC单位的第一组患者更显著、更规律。本文讨论了这些生物学变化的细胞机制。当需要快速且最大程度地停止Paget病的骨重建时,建议采用每日两次注射50 MRC单位SCT的给药方案。