Lind L, Wengle B, Lithell H, Ljunghall S
Department of Internal Medicine, Uppsala University Hospital, Sweden.
Scand J Urol Nephrol. 1991;25(3):233-6. doi: 10.3109/00365599109107953.
Raised levels of alkaline phosphatases (ALP) are seen in conditions with a high bone turn-over, such as in primary and secondary hyperparathyroidism (HPT). To study the effects of active vitamin D treatment on ALP, alphacalcidol (1-alpha-hydroxyvitamin D3), was given to patients with primary HPT as well as HPT secondary to chronic renal failure and also to healthy, euparathyroid subjects. Oral alphacalcidol (1 microgram daily) significantly reduced serum ALP (3.2 +/- 1.1 to 2.8 +/- 1.2 mu kat/l, p less than 0.05) in a 6-month double-blind, placebo-controlled study in patients with mild primary HPT, and alphacalcidol given intravenously to uremic subjects induced a reduction in serum ALP levels (3.5 +/- 3.1 to 2.6 +/- 1.7 mu kat/l, p less than 0.05) during a 4 months' study. A reduction in serum ALP was also seen in the euparathyroid subjects (2.4 +/- 0.77 to 2.2 +/- 0.64 mu kat/l, p = 0.03). This study indicates that treatment with active vitamin D is effective in reducing the increased bone turnover seen in subjects with both primary and secondary HPT.
在骨转换率高的情况下，如原发性和继发性甲状旁腺功能亢进症（HPT），碱性磷酸酶（ALP）水平会升高。为研究活性维生素D治疗对ALP的影响，对原发性HPT患者、慢性肾衰竭继发的HPT患者以及健康的甲状旁腺功能正常的受试者给予阿法骨化醇（1α-羟基维生素D3）。在一项针对轻度原发性HPT患者的为期6个月的双盲、安慰剂对照研究中，口服阿法骨化醇（每日1微克）可显著降低血清ALP水平（从3.2±1.1降至2.8±1.2微卡特/升，p<0.05）；在一项为期4个月的研究中，对尿毒症患者静脉注射阿法骨化醇可使血清ALP水平降低（从3.5±3.1降至2.6±1.7微卡特/升，p<0.05）。在甲状旁腺功能正常的受试者中也观察到血清ALP降低（从2.4±0.77降至2.2±0.64微卡特/升，p = 0.03）。这项研究表明，活性维生素D治疗可有效降低原发性和继发性HPT患者中出现的骨转换增加。
