Coiro V, Zanardi G, Saccani Jotti G, Rubino P, Manfredi G, Chiodera P
Department of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy.
Minerva Endocrinol. 2008 Mar;33(1):7-13.
The aim of this study was to test the possibility of enhancing blood calcium levels in totally thyroidectomized patients by supplementation with 1 L/d carbonate-bicarbonate-high-calcium mineral water.
This study enrolled 95 outpatients, totally thyroidectomized four months earlier, and hence treated with oral calcium and vitamin-D. At recruitment, ionized blood calcium was either below (Group A; N. 55) or above (Group B; N. 40, randomly divided in Group B1 [N. 20] and Group B2 [N.20]) the lower limit of the normal range (1.12 mmol/L). For one month, Group A was treated with 1 L/d high-calcium (483 mg/L) mineral water and continued the usual therapy with Ca and vitamin-D. In contrast, Group B1 and Group B2 substituted their Ca and vitamin-D therapy with 1 L/d high-calcium mineral water (Group B1) or 1 L/d of placebo mineral water (Ca:80 mg/L) (Group B2).
After one month, a significant 7.5% increase in blood ionized-calcium levels was observed in Group A, no change in Group B1 and a significant drop below normality in Group B2 (Group B2 vs Group B1, P<0.001). Thereafter, 1 L/d of the high-calcium mineral water, given to Group B2 instead of placebo for an additional month, significantly enhanced ionized-calcium levels above the lower limit of normality (Group B2 vs Group B1, NS).
These experiments show that calcium supplementation as 1 L/d of a high-calcium mineral water may efficaciously enhance blood calcium levels in thyroidectomized patients. This complementary treatment might at least in part contribute to the prevention and/or treatment of hypocalcemia and substitute vitamin-D and calcium therapies after thyroidectomy.
本研究旨在测试通过补充每日1升碳酸钙-碳酸氢盐-高钙矿泉水来提高全甲状腺切除患者血钙水平的可能性。
本研究招募了95名门诊患者，他们在四个月前接受了全甲状腺切除术，因此正在接受口服钙和维生素D治疗。在招募时，离子血钙水平低于（A组；55例）或高于（B组；40例，随机分为B1组[20例]和B2组[20例]）正常范围下限（1.12 mmol/L）。A组连续一个月每日饮用1升高钙（483毫克/升）矿泉水，并继续接受常规钙和维生素D治疗。相比之下，B1组和B2组分别用每日1升高钙矿泉水（B1组）或每日1升安慰剂矿泉水（钙含量80毫克/升）（B2组）替代其钙和维生素D治疗。
一个月后，A组血液离子钙水平显著升高7.5%，B1组无变化，B2组显著降至正常范围以下（B2组与B1组相比，P<0.001）。此后，B2组改用每日1升高钙矿泉水而非安慰剂，持续一个月，离子钙水平显著升至正常范围下限以上（B2组与B1组相比，无显著性差异）。
这些实验表明，每日补充1升高钙矿泉水可有效提高甲状腺切除患者的血钙水平。这种辅助治疗可能至少部分有助于预防和/或治疗低钙血症，并替代甲状腺切除术后的维生素D和钙治疗。
