Cantini F, Niccoli L, Bellandi F, Di Munno O
II Division of Internal Medicine, Hospital of Prato, Italy.
Clin Rheumatol. 1995 Nov;14(6):663-6. doi: 10.1007/BF02207933.
To evaluate the effects of the short-term, high-dose sodium heparin therapy on biochemical markers of bone metabolism, we studied 20 patients (11 males and 9 females) with pulmonary embolism, treated with sodium heparin (daily dose range: 40,000-45,000 I.U. by continuous i.v. infusion). Heparin therapy lasted 5-7 days, after which patients received warfarin over 12 months. Eleven patients (6 males and 5 females) with ischaemic stroke, treated with i.v. glycerol and pentoxifilline, were used as controls. Before and after therapy serum and urinary markers of bone metabolism were evaluated; in 12 heparin-treated pts., the parameters were also evaluated 4 months after discontinuation of warfarin therapy. After heparin therapy a significant reduction vs. basal value was observed in levels of serum osteocalcin (ng/ml;mean + SEM): 3.32 & 0.19 vs. 2.05 + 0.21; p < 0.001. In the 12 patients evaluated 4 months after discontinuation of warfarin therapy, serum osteocalcin levels returned to basal value: 3.41 + 0.12 ng/ml (p:n.s.). No significant changes of the examined parameters were observed in controls. In conclusion, our data seem to indicate an effect of i.v. short-term heparin therapy on bone metabolism. This effect seems to be characterized by an inhibition of osteoblast function as suggested by the reduction of serum osteocalcin levels.
为评估短期大剂量肝素钠治疗对骨代谢生化指标的影响，我们研究了20例肺栓塞患者（11例男性，9例女性），给予肝素钠治疗（每日剂量范围：40,000 - 45,000国际单位，持续静脉输注）。肝素治疗持续5 - 7天，之后患者接受华法林治疗12个月。11例缺血性中风患者（6例男性，5例女性），接受静脉注射甘油和己酮可可碱治疗，作为对照。在治疗前后评估骨代谢的血清和尿液指标；在12例接受肝素治疗的患者中，在停用华法林治疗4个月后也评估了这些参数。肝素治疗后，血清骨钙素水平（ng/ml；均值±标准误）较基础值显著降低：3.32±0.19 vs. 2.05±0.21；p<0.001。在停用华法林治疗4个月后评估的12例患者中，血清骨钙素水平恢复到基础值：3.41±0.12 ng/ml（p：无统计学意义）。在对照组中未观察到所检查参数的显著变化。总之，我们的数据似乎表明静脉注射短期肝素治疗对骨代谢有影响。如血清骨钙素水平降低所提示，这种影响似乎以抑制成骨细胞功能为特征。
