Davies P D, Church H A, Brown R C, Woodhead J S
Department of Thoracic Medicine, Llandough Hospital, Penarth, South Glamorgan, U.K.
Eur J Respir Dis. 1987 Nov;71(5):341-4.
Reports of raised serum calcium in the presence of tuberculosis have tended to be from centres where sunlight is plentiful. U.K.-based data have suggested that normocalcaemia prevails. In a prospective study of 15 African patients with pulmonary tuberculosis, resident in East Africa, corrected serum calcium was significantly lower in a control healthy group (2.59 mmol/l +/- 0.08 and 2.49 +/- 0.06 mmol/l respectively: P less than 0.001). Serum 25-hydroxy vitamin D was significantly lower in the patient group (median, 15.9 ng/ml, range 6.7-35.7) compared with the control group (median 26.2 ng/ml, range 10.5-45.9, P less than 0.05). No significant difference was found between patients and controls for 1,25-dihydroxy vitamin D or parathyroid hormone. No correlation was found between serum calcium and 1,25 (OH)2 D3. Serum albumin showed a negative correlation with radiographic extent of disease and with extent of cavitation. Where sunlight is plentiful, relatively high serum 25-hydroxy Vitamin D may give rise to raised serum calcium in the presence of tuberculosis.
关于结核病患者血清钙升高的报告往往来自阳光充足的地区。英国的数据表明正常血钙水平更为普遍。在一项对15名居住在东非的非洲肺结核患者的前瞻性研究中，患者组校正后的血清钙显著低于健康对照组（分别为2.59 mmol/l±0.08和2.49±0.06 mmol/l：P<0.001）。患者组血清25-羟维生素D显著低于对照组（中位数为15.9 ng/ml，范围为6.7 - 35.7），而对照组中位数为26.2 ng/ml，范围为10.5 - 45.9，P<0.05）。患者与对照组在1,25-二羟维生素D或甲状旁腺激素方面未发现显著差异。血清钙与1,25(OH)₂D₃之间未发现相关性。血清白蛋白与疾病的影像学范围以及空洞形成范围呈负相关。在阳光充足的地区，相对较高的血清25-羟维生素D可能在结核病患者中导致血清钙升高。
