Martinez M E, Gonzalez J, Sanchez-Cabezudo M J, Peña J M, Vazquez J J
Biochemistry Department, Hospital "La Paz", Universidad Aut-onoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain.
Calcif Tissue Int. 1996 Jul;59(1):17-20. doi: 10.1007/s002239900078.
The hypercalciuria evolution and other bone metabolism parameters were evaluated in patients with tuberculosis after treatment. Twenty-two patients with tuberculosis and 54 normal subjects were studied; they consumed an average diet (calcium intake 1000 mg/day). Ten of these patients and nine normal subjects were also studied after a low calcium diet (400 mg/calcium/day) and after a load of oral calcium of 1000 mg (calcium absorption test). The study with an average diet was performed after 1 week (basal) and 3, 6, and 12 months after the antituberculosis treatment was started; the calcium absorption test was carried out 2 weeks, 3 and 12 months after the treatment was started. On an average diet, patients with tuberculosis presented, at baseline state, lower calcidiol levels than normal controls. Serum calcitriol levels at baseline were higher than at 6 and 12 months. Serum parathyroid hormone (PTH) levels in patients with tuberculosis were lower than in normal controls at baseline, but these levels were similar to controls at 3, 6, and 12 months after treatment. During the calcium absorption test and under basal conditions, patients with tuberculosis showed lower serum PTH and calcidiol levels in all the dietetic situations than in normal controls. However, serum calcitriol levels were higher than in controls after the restrictive diet. After 3 months of treatment, urinary calcium excretion was normal in patients with tuberculosis during the average and low diets, but higher than in control group after calcium load. After 12 months of treatment, all the biochemical parameters of the patients with tuberculosis were similar to the control group under all the dietetic situations. These data indicate that antituberculous treatment, although it may contribute to the production of some alteration in the calcium and vitamin D metabolism, basically favors the correction of disturbances associated with tuberculosis.
对结核病患者治疗后的高钙尿症演变及其他骨代谢参数进行了评估。研究了22例结核病患者和54名正常受试者；他们摄入平均饮食（钙摄入量为1000毫克/天）。其中10例患者和9名正常受试者还在低钙饮食（400毫克/钙/天）及口服1000毫克钙负荷后（钙吸收试验）进行了研究。平均饮食研究在抗结核治疗开始后1周（基础值）以及3、6和12个月时进行；钙吸收试验在治疗开始后2周、3个月和12个月时进行。在平均饮食情况下，结核病患者在基线状态时的骨化二醇水平低于正常对照组。基线时血清骨化三醇水平高于6个月和12个月时。结核病患者的血清甲状旁腺激素（PTH）水平在基线时低于正常对照组，但在治疗后3、6和12个月时与对照组相似。在钙吸收试验期间及基础条件下，结核病患者在所有饮食情况下的血清PTH和骨化二醇水平均低于正常对照组。然而，在限制饮食后，血清骨化三醇水平高于对照组。治疗3个月后，结核病患者在平均饮食和低钙饮食时尿钙排泄正常，但在钙负荷后高于对照组。治疗12个月后，结核病患者的所有生化参数在所有饮食情况下均与对照组相似。这些数据表明，抗结核治疗虽然可能会导致钙和维生素D代谢出现一些改变，但基本上有利于纠正与结核病相关的紊乱。
