Kanis J A, Urwin G H, Gray R E, Beneton M N, McCloskey E V, Hamdy N A, Murray S A
Am J Med. 1987 Feb 23;82(2A):55-70. doi: 10.1016/0002-9343(87)90488-8.
The induction of hypercalcemia in malignant disease is almost invariably associated with increased bone resorption. However, tumor-induced changes in bone formation and renal tubular resorption of calcium are also important factors that induce hypercalcemia in some patients. In addition, alterations in calcium fluxes to and from the extracellular fluid secondary to hypercalcemia are important in maintaining or aggravating the hypercalcemic effects of increased bone resorption. These factors significantly affect the responses to treatment of hypercalcemia with inhibitors of bone resorption. This study examined the relative importance of these factors and the effects of intravenous etidronate disodium (etidronate) in neoplastic bone disease with and without hypercalcemia and in Paget's disease of bone. It is concluded that intravenous etidronate is an effective inhibitor of bone resorption, which accounts in large measure for its effects on serum calcium concentrations. These studies of etidronate in hypercalcemia suggest the response is sustained for several weeks.
恶性疾病中高钙血症的诱发几乎总是与骨吸收增加相关。然而，肿瘤引起的骨形成变化以及肾小管对钙的重吸收也是导致部分患者出现高钙血症的重要因素。此外，继发于高钙血症的钙在细胞外液的流入和流出变化，对于维持或加重骨吸收增加所致的高钙血症效应也很重要。这些因素显著影响了使用骨吸收抑制剂治疗高钙血症的反应。本研究探讨了这些因素的相对重要性，以及静脉注射依替膦酸二钠（依替膦酸）对伴有或不伴有高钙血症的肿瘤性骨病以及佩吉特骨病的影响。得出的结论是，静脉注射依替膦酸是一种有效的骨吸收抑制剂，这在很大程度上解释了其对血清钙浓度的影响。这些关于依替膦酸治疗高钙血症的研究表明，该反应可持续数周。
