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[原发性胆汁性肝硬化中的骨质减少。对20例患者的研究]

[Osteopenia in primary biliary cirrhosis. Study in 20 patients].

作者信息

Pumarino H, Brahm J, Oviedo S, Lillo R, González P

机构信息

Seccione de Endocrinología, Facultad de Medicina (Campus Norte), Universidad de Chile, Hospital José Joaquín Aguirre, Santiago.

出版信息

Rev Med Chil. 1994 Dec;122(12):1398-403.

PMID:7659915
Abstract

We studied 20 female patients, aged 51 +/- 13.6 years old, with the diagnosis of Primary Biliary Cirrhosis (PBC) to assess osteopenia, main involved sites and its relation to menopause, some parameters of mineral metabolism and the degree of histological liver involvement. The diagnosis of PBC was based in histological, clinical and laboratory features. Bone densitometry was measured with a dual-photon densitometer and compared with values of a normal female population from the laboratory. When compared to controls, studied patients had a significantly lower lumbar spine bone density and total bone mineral content and a non significantly lower density in femoral neck and total body. Serum calcium, phosphorus, magnesium, PTH and urinary calcium/creatinine ratio were within normal limits. Lumbar spine density was not significantly lower in patients with more severe liver histological involvement and in postmenopausal women. No correlation was found between the duration of postmenopausal period and the degree of osteopenia. It is concluded that patients with PBC have a clear lumbar spine osteopenia and a lower total mineral content and that these parameters worsen in a non significant fashion in subjects along with liver histological involvement and with the length of post menopausal period.

摘要

我们研究了20名年龄在51±13.6岁之间、诊断为原发性胆汁性肝硬化(PBC)的女性患者,以评估骨质减少情况、主要受累部位及其与绝经的关系、矿物质代谢的一些参数以及肝脏组织学受累程度。PBC的诊断基于组织学、临床和实验室特征。使用双能光子骨密度仪测量骨密度,并与实验室正常女性人群的值进行比较。与对照组相比,研究患者的腰椎骨密度和总骨矿物质含量显著降低,股骨颈和全身密度降低但无统计学意义。血清钙、磷、镁、甲状旁腺激素(PTH)和尿钙/肌酐比值均在正常范围内。肝脏组织学受累更严重的患者和绝经后女性的腰椎密度无显著降低。绝经后持续时间与骨质减少程度之间未发现相关性。结论是,PBC患者存在明显的腰椎骨质减少和较低的总矿物质含量,并且这些参数在伴有肝脏组织学受累和绝经后时间延长的患者中虽无显著恶化但仍有加重趋势。

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