磷对全胃肠外营养期间内源性钙丢失的影响。

Effect of phosphorus on endogenous calcium losses during total parenteral nutrition.

作者信息

Wood R J, Sitrin M D, Rosenberg I H

机构信息

Section of Gastroenterology, Department of Medicine, University of Chicago, IL.

出版信息

Am J Clin Nutr. 1988 Sep;48(3):632-6. doi: 10.1093/ajcn/48.3.632.

DOI:10.1093/ajcn/48.3.632

PMID:2843026

Abstract

Intravenous phosphorus can reduce urinary calcium losses in patients receiving total parenteral nutrition (TPN). We investigated the effect of intravenous P on urinary and fecal Ca loss in intravenously fed normal and thyroparathyroidectomized (TPTX) rats to assess the role of parathyroid hormone (PTH) and endogenous fecal Ca losses. Doubling the intravenous P load during TPN decreased urinary Ca losses by 54% (0.299 vs 0.137 mmol/d) in intact rats and by 43% (0.514 vs 0.294 mmol/d) in TPTX rats. Increased P load in normal rats had no effect on urinary cyclic AMP excretion, serum Ca, serum P, serum 1,25-dihydroxycholecalciferol, or endogenous fecal Ca losses. These observations suggest that the hypocalciuric effect of P during TPN is independent of PTH and is not caused by a repartitioning of obligatory Ca losses from the renal to the intestinal route.

摘要

静脉输注磷可减少接受全胃肠外营养（TPN）患者的尿钙流失。我们研究了静脉输注磷对静脉喂养的正常大鼠和甲状旁腺切除（TPTX）大鼠尿钙和粪钙流失的影响，以评估甲状旁腺激素（PTH）和内源性粪钙流失的作用。在TPN期间将静脉磷负荷加倍，可使完整大鼠的尿钙流失减少54%（从0.299 mmol/d降至0.137 mmol/d），使TPTX大鼠的尿钙流失减少43%（从0.514 mmol/d降至0.294 mmol/d）。正常大鼠增加磷负荷对尿中环磷酸腺苷排泄、血清钙、血清磷、血清1,25-二羟胆钙化醇或内源性粪钙流失均无影响。这些观察结果表明，TPN期间磷的降钙尿作用独立于PTH，并非由强制性钙流失从肾脏途径重新分配至肠道途径所致。