Objective To investigate the effects of calcitriol on thyroid hormone and bone mineral density in patients with hyperthyroidism.Methods One hundred and sixty cases of patients with hyperthyroidism were selected, who were treated in hospital from January 2015 to January 2017, and they were divided into the observation group (80 cases) and control group (80 cases).The patients of two groups were all treated with full rest, vitamin supplements, calcium, nutritional support and other conventional treatment.The patients of control group were treated with methimazole (oral, 10 mg / time, 1 time / d).On the basis of control group, the patients of observation group were treated with ossification triol capsules (oral, 0.25 μg/ time, 2 times/d).The patients of two groups were all treated for 6 weeks.The adverse reactions and changes of the levels of FT3, FT4, TSH, Ca, P, Mg, ALP, UCa, and femoral neck, L2~3, hip bone mineral density, Barthel index, pain score of two groups were compared.Results After the appropriate treatment, the levels of FT3, FT4 of two groups were all significantly lower than before(t=54.426,t=46.067,t=43.421,t=52.393,P=0.000,P=0.000,P=0.000,P=0.000), the levels of TSH of two groups were all significantly higher than before(t=71.415,t=76.752,P=0.000,P=0.000), but the difference between the two groups was not statistically significant (t=0.416,t=0.197,t=1.036,P=0.339,P=0.422,P=0.151);The levels of Mg, femoral neck, L2~3, hip bone mineral density, Barthel index of the observation group were significantly higher than those of the control group(t=1.789,t=6.828,t=6.028,t=6.325,t=12.274,P=0.038,P=0.000,P=0.000,P=0.000,P=0.000), the levels of UCa, pain score of the observation group were significantly lower than those of the control group (t=3.858,t=29.080,P=0.000,P=0.000), but there were no significant difference in Ca, P and ALP between the two groups (t=0.537,t=0.308,t=0.792,P=0.296,P=0.379,P=0.215);There were nausea, diarrhea, rash, hypothyroidism, goiter, granulocyte deficiency, liver damage and other adverse reactions occurred in both two groups, but there were no statistically significant between the two groups (P>0.05).Conclusion Treating patients with hyperthyroidism, calcitriol can effective control the thyroid hormone levels, improve bone density and clinical symptoms of pain, and it is safe and reliable, which makes it have clinical promotional value.%目的 观察骨化三醇对甲状腺功能亢进患者甲状腺激素及骨密度等的影响.方法 选择2015年1月-2017年1月湖北省潜江市江汉油田总医院内三科诊治的甲状腺功能亢进患者160例作为研究对象,采用数字表法随机分为观察组和对照组各80例.2组患者均给予充分休息,补充维生素、钙类及营养支持等常规治疗.对照组在常规治疗基础上给予甲巯咪唑口服,10 mg/次,1次/d;观察组在对照组治疗基础上联合应用骨化三醇胶丸口服,0.25 μg/次,2次/d;2组患者疗程均为6周.比较2组患者治疗前后FT3、FT4、TSH、Ca、P、Mg、ALP、UCa及股骨颈、L2~3、髋关节骨密度、Barthel指数、疼痛评分,并记录2组患者药物不良反应发生情况,进行安全性评价.结果 与治疗前比较,2组患者治疗后FT3、FT4明显降低,TSH水平显著升高(P<0.01);而2组治疗后比较差异无统计学意义(P>0.05);观察组治疗后血Mg、股骨颈、L2~3、髋关节骨密度、Barthel指数明显高于对照组(P<0.05),UCa、疼痛指数显著低于对照组(P<0.01),而Ca、P、ALP差异无统计学意义(P>0.05);2组患者治疗过程中均发生恶心、腹泻、皮疹、甲状腺功能减退、甲状腺肿、粒细胞缺乏、肝功能损害等不良反应,2组间比较差异无统计学意义(P>0.05).结论 骨化三醇治疗甲状腺功能亢进患者可有效控制甲状腺激素水平,提高骨密度,改善临床疼痛症状,安全可靠,具有临床推广价值.
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