目的 探讨甲状腺机能亢进症(甲亢)患者不同部位的骨密度(BMD)变化及骨量丢失的情况.方法 采用双能X线骨吸收仪测定2008年4月-2009年11月我科门诊收治的150例甲亢患者的腰椎、股骨颈、桡骨远端骨密度,同时与年龄、性别、身高、体质量相匹配的同期在我院体检的176例对照组的骨密度进行比较.结果 绝经前女性甲亢患者腰椎、股骨颈、桡骨远端的骨密度分别为(1.074±0.116)g/cm2、(0.877±0.112)g/cm2、(0.739±0.108)g/cm2,较对照组的(1.257±0.149)g/cm2、(0.994±0.151)g/cm2、(0.850±0.075)g/cm2下降;绝经后女性甲亢患者的腰椎、桡骨远端的骨密度分别为(0.935±0.129)g/cm2、(0.625±0.111)g/cm2,较对照组的(1.019±0.148)g/cm2、(0.785±0.095)g/cm2下降;＜50岁男性甲亢患者腰椎、股骨颈、桡骨远端的骨密度分别为(1.063±0.098)g/cm2、(0.855±0.124)g/cm2、(0.746±0.152)g/cm2,较对照组的(1.196±0.106)g/cm2、(1.018±1.022)g/cm2、(0.963±0.063)g/cm2下降;≥50岁男性甲亢患者股骨颈、桡骨远端的骨密度为(0.845±0.008)g/cm2、(0.763±0.094)g/cm2,较对照组的(0.924±0.100)g/cm2、(0.923±0.103)g/cm2明显下降,差异均有统计学意义(P＜0.05).同时将三个部位之间进行两两比较,发现以桡骨远端的骨密度下降最为显著.结论 甲亢对患者骨量丢失的影响较大,其中以皮质骨为主的桡骨远端的骨量丢失最为显著.%To investigate the changes of bone mineral density ( BMD ) at different skeletal sites in patients with hyperthyroidism. Methods A total of 150 outpatients with hyperthyroidism visiting our clinic between April 2008 and November 2009 were included in the study group, and 176 people doing health checkups in our hospital during the same period were included in the control group. The age, gender, height, and weight of the subjects of the two groups matched well. The BMD at lumbar, femoral neck, distal radius of all subjects was measured with dual energy X - ray absorptiometry ( DXA ) . Results For premenopausal females, the subjects in the study group had lower BMD at lumbar-, femoral neck, and distal radius than those in the control group. For postmenopausal females, the subjects in the study group had lower BMD at lumbar and distal radius than those in the control group. No significant difference was found in BMD at femoral neck. For males under 50 years old, the subjects in the study group had lower BMD at lumbar, femoral neck, and distal radius than those in the control group. For males aged 50 years old and above, the subjects in the study group had lower BMD at femoral neck and distal radius. The distal radius had the largest BMD change among the three sites. Conclusion Hyperthyroidism induces bone loss, and the most significant bone loss happens at the distal radius which mainly consists of cortical bone.
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