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甲状旁腺切除术后骨骼和血清矿物质的变化及其门腔分流术预防措施

Changes in bone and serum minerals after parathyroidectomy and their prevention by portacaval shunt.

作者信息

Al-Jurf A S, Smith G L

出版信息

Metabolism. 1981 Jun;30(6):544-8. doi: 10.1016/0026-0495(81)90128-1.

Abstract

The effect of portacaval shunt and parathyroidectomy on the concentration of calcium, magnesium, phosphate and hydroxyproline in the bone and the concentration of the three minerals in the serum has been studied in the growing rat. Parathyroidectomy produced a decreased net bone reabsorption as evidenced by higher concentrations of calcium, magnesium and phosphate; and a reduced net matrix formation, as evidenced by lower concentrations of hydroxyproline. Portacaval shunt, when performed with parathyroidectomy, prevented the development of these changes and produced "normal" concentrations of most of those elements, comparable to their concentrations in the control animals. The changes in serum calcium and magnesium produced by parathyroidectomy were prevented when portacaval shunt was performed in conjunction with the former procedure. Portacaval shunt alone produced no significant changes except for hypophosphatemia. This hypophosphatemia is speculated to have stimulated the production of 1,25-(OH)2D3 in the kidney, which in turn produced those observed effects of portacaval shunt in the parathyroidectomized rat.

摘要

在生长中的大鼠身上,研究了门腔静脉分流术和甲状旁腺切除术对骨骼中钙、镁、磷和羟脯氨酸浓度以及血清中这三种矿物质浓度的影响。甲状旁腺切除术导致净骨重吸收减少,表现为钙、镁和磷浓度升高;净基质形成减少,表现为羟脯氨酸浓度降低。当门腔静脉分流术与甲状旁腺切除术同时进行时,可防止这些变化的发生,并使大多数元素的浓度“正常化”,与对照动物中的浓度相当。当门腔静脉分流术与甲状旁腺切除术联合进行时,可防止甲状旁腺切除术引起的血清钙和镁变化。单独进行门腔静脉分流术除了导致低磷血症外,没有产生显著变化。推测这种低磷血症刺激了肾脏中1,25-(OH)2D3的产生,进而产生了在甲状旁腺切除大鼠中观察到的门腔静脉分流术的那些效应。

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