胃旁路术与骨代谢.PDF

生垦量亟堕丛苤查!Q!!生!旦筮!!鲞筮!塑竺!垫』Q!!!!P!翌!!叁!壁壁!!!!!!!!!!：坠：! 745 !!!!!!!!!!望!i!!!!型：!!!!墅鲤!!!：!!翌：!!!!i；!望：!!!14：!!!!：!Q壁!：!!Q!：!!!!：Q!：!!! ·综3_z13- 胃旁路术与骨代谢 朱紫薇金晖 中图分类号：R656．6+l：R589．5文献标识码：A 文章编号：1006-7108(2011)08-0745-04 摘要：肥胖症在世界范围内的发病率逐渐升高，胃旁路术是近年来减肥手术的主要方法之一。手术 成功减肥后，骨代谢指标以及骨质量的变化正日益受到重视。术后患者体内钙、维生素D的缺乏引 发了PTH升高与BMD下降，PTH升高可引起继发性甲状旁腺功能亢进，骨生成尤其是骨吸收活跃， 严重者可导致骨质疏松症。胃旁路术后患者体内脂肪组织减少，导致瘦素产生减少、脂联素产生增 加，进而引起骨密度下降。术后补充一定量钙及维生素D可部分纠正二者的缺乏，但具体剂量尚不 清楚。定期检测患者体内PTH、Ca、VitD、骨转换指标、监测骨密度变化等有利于了解胃旁路术对骨 代谢的长期影响。 关键词：胃旁路手术；维生素D；骨转换；脂联素；瘦素 Roux-en-Y andbonemetabolismZHU bypass Ziwei，fiN of gastric Hui．DepartmentEndocrinology， the Southeast 21 0009。China AffiliatedZhongdaHospitalof University，No雌ng author：JINHui，Email：jinhuison@126．com Corresponding the of hasbecomeoneofthe Abstract：With obesity，Roux—en-Ygastricbypass major increasingprevalence bariatric inrecent attentionhasbeen inthe ofbonemetabolicmarkers surgeries years．More paid changes andbonemassafterthesuccessfulfor reduction．Afterthe ofcalcium surgeryweight surgery，thedeficiency andvitamin leadtOaincreaseofthe decreaseofthebone D(VitD)can parathyroidhormone(PTH)and marrow increaseofPTHcancausethe activates density(BMD)．The secondaryhyperparathyroidism，which in insevere the boneformationand bone cases．Becauseof especiallyresorption，resultingosteoporosis in with andthe reductionofthe