Chesney R W, McCarron D M, Haddad J G, Hawker C D, DiBella F P, Chesney P J, Davis J P
J Lab Clin Med. 1983 Apr;101(4):576-85.
Hypocalcemia is a common finding in TSS. This has been causally related to the hypoalbuminemia of TSS. To more clearly define the mechanism responsible for this hypocalcemia, we examined the serum concentrations of CaT, Ca+ +, iCT, albumin, and DBP in 28 women meeting the case-study definition of TSS. Mean CaT was 2.18 +/- 0.36 mM/L (S.D.), Ca+ + was 0.93 +/- 0.19 mM/L, and iCT was 1941 +/- 978 pg/ml; all were significantly different (p less than 0.01) from the normal values of CaT (2.38 +/- 0.09), Ca+ + (1.09 +/- 0.04) and iCT (less than 30 to 135). A significant inverse correlation was found between iCT and both CaT and Ca+ +, p less than 0.001. Serial values were measured in two women in whom the iCT values declined each day. Gel filtration of the iCT from two patients with the highest values suggested that some polymeric molecular species, rather than authentic CT, accounted for 90% of the circulating iCT value. No abnormalities of DBP levels were found, and no correlation with CaT, Ca+ +, or iCT was evident. The hypocalcemia of the TSS represents a reduction in both CaT and Ca+ + concentrations, which may be at least partially accounted for by the elevated iCT concentrations.
低钙血症是中毒性休克综合征（TSS）的常见表现。这与TSS的低白蛋白血症存在因果关系。为了更清楚地确定导致这种低钙血症的机制，我们检测了28名符合TSS病例研究定义的女性的血清总钙（CaT）、离子钙（Ca++）、免疫反应性降钙素（iCT）、白蛋白和维生素D结合蛋白（DBP）浓度。平均CaT为2.18±0.36 mM/L（标准差），Ca++为0.93±0.19 mM/L，iCT为1941±978 pg/ml；所有这些值与CaT（2.38±0.09）、Ca++（1.09±0.04）和iCT（小于30至135）的正常值均有显著差异（p＜0.01）。发现iCT与CaT和Ca++均呈显著负相关，p＜0.001。对两名iCT值每天下降的女性进行了连续检测。对两名iCT值最高的患者的iCT进行凝胶过滤分析表明，一些聚合分子形式而非真正的降钙素占循环中iCT值的90%。未发现DBP水平异常，且其与CaT、Ca++或iCT无明显相关性。TSS的低钙血症表现为CaT和Ca++浓度均降低，这可能至少部分是由iCT浓度升高所致。
