维生素K2结合钙剂在甲状腺功能亢进症继发骨质疏松症中的临床应用

摘要

目的 探讨维生素K2对甲状腺功能亢进性骨质疏松症患者骨密度、骨代谢指标及细胞因子水平变化的影响.方法选取2014年7月至2015年7月来我院治疗的57例甲状腺功能亢进性骨质疏松症患者作为研究对象,随机分为治疗组( n＝29)和对照组(n＝28).对照组给予钙剂治疗,治疗组给予维生素K2联合钙剂治疗,为期12个月.检测所有对象治疗前后髋部及腰椎的骨密度(bone mineral density,BMD)、骨代谢指标[骨钙素(osteocalcin,BGP)和总Ⅰ型前胶原氨基端延长肽( total N-terminal propeptide of type Ⅰ procollagen,PINP)]以及细胞因子[胰岛素样生长因子-1(insulin-like growth factor,IGF-1)、白细胞介素(interleukin,IL)-2、6(IL-2、IL-6)],并进行比较.结果 治疗前,两组患者的BMD、BGP、PINP及IL-2、IL-6和IGF-1比较差异无统计学意义(P＞0. 05);治疗12个月后,治疗组髋部及腰椎的BMD水平显著高于对照组(P＜0. 05);治疗组BGP、PINP水平显著低于对照组(P＜0. 05);治疗组IL-2 水平显著高于对照组(P＜0. 05);治疗组IL-6 和IGF-1 水平显著低于对照组(P＜0. 05).结论 维生素K2可以明显提高甲状腺功能亢进性骨质疏松患者的骨密度、降低骨转换,提高IL-2表达且降低IL-6 和IGF-1水平,对骨质疏松有保护作用.%Objective To investigate the effect of vitamin K2on bone mineral density, bone metabolism and cytokine levels in patients with hyperthyroidism osteoporosis. Methods 57 patients with hyperthyroidism osteoporosis treated in our hospital from July 2014 to July 2015 were randomly divided into treatment group ( n＝29) and control group ( n＝28). The control group was treated with calcium, and the treatment group was treated with vitamin K2combined with calcium for 12 months. Bone mineral density (BMD) of hip and lumbar spine, bone metabolic index (BGP, PINP) and cytokines (IL-2, IL-6 and IGF-1) were examined and compared before and after treatment. Results Before treatment, BMD, BGP, PINP, IL-2, IL-6 and IGF-1 of the two groups had no significant differences ( P ＞ 0. 05 ). After 12 months of treatment, BMD of hip and lumbar spine were significantly higher than those in the control group ( P ＜0. 05), and the levels of BGP and PINP in the treatment group were significantly lower than those in the control group (P＜0. 05). The level of IL-2 in the treatment group was significantly higher than that in the control group ( P＜0. 05) and IL- 6 and IGF-1 levels were significantly lower than those in the control group ( P ＜0. 05). Conclusion Vitamin K2could significantly improve bone mineral density, reduce bone turnover, increase IL-2 expression and decrease IL-6 and IGF-1 levels in patients with secondary osteoporosis of hyperthyroidism, thus has protective effect to osteoporosis.