肝硬化患者血清钙磷及钙调节激素的检测及意义

Significance of detecting serum calcium, serum phosphorus and calcium-regulating hormones in patients with hepatic cirrhosis

摘要:

目的  探讨检测肝硬化患者血清钙磷及钙调节激素包括甲状旁腺激素（PTH）、降钙素（CT）及25-羟维生素D3[25-（OH）D3]的临床意义。方法  釆集83例肝硬化患者及66例正常人的血清，血清钙测定用偶氮砷Ⅲ比色法，血清磷测定用磷钼酸盐法；甲状旁腺激素、降钙素及2-羟维生素D3的测定采用电化学发光法。结果  Child-pugh C级肝功能患者与对照组、Ａ级及Ｂ级比较血清钙降低（P <0.05），血磷的变化在4组患者之间差异无统计学意义。C级肝功能患者与对照组、A级及B级比较CT（P <0.05）及25-（OH）D3（P < 0.01）降低，PTH升高（P <0.01）。结论  肝硬化患者存在血清钙及其调节激素的代谢紊乱，并随病情发展而加重。监测肝硬化血清钙及相关激素水平的变化可能有助于判断肝功能损害程度。

Abstract:

Objective To evaluate clinical significance of detecting serum calcium, serum phosphorus and calcium-regulating hormones, including parathyroid hormone (PTH), calcitonin (CT) and 25-hydroxyvitamin D3 [25-(OH)D3] in patients with hepatic cirrhosis. Methods We collected serum samples of 83 patients with hepatic cirrhosis and 66 normal people. Serum calcium was detected by Arsenazo Ⅲ colorimetric method and serum phosphorus by molybdophosphate photometric method; Electrochemiluminescence method was used to detect parathyroid hormone, calcitonin and 25-hydroxyvitamin D3. Results In Child-pugh class C patients, serum calcium levels was significantly lower than in control group and in class A and B patients (P < 0.05). Serum phosphorus level was no significantly different in the four groups. Child-pugh class C patients had significantly lower 25-(OH) D3 (P < 0.01) and CT (P < 0.05) level, but higher PTH (P < 0.01) level compared with control group and with class A and B. Conclusions In patients with hepatic cirrhosis, there were disturbances of serum calcium and calcium-regulating hormone, which deteriorate with the disease development. It is helpful for evaluating the degree of hepatic injury to monitor the levels of serum calcium and calcium-regulating hormones in patients with hepatic cirrhosis.