论文部分内容阅读
目的探讨慢性肾脏病(CKD)患者指骨骨密度(BMD)的变化以及其与相关生化指标之间的关系,以期早期诊断肾性骨病。方法选取CKD患者75例,分为透析组(38例)和非透析组(37例)。另外选取30例健康人作为对照组。测定105例受试者生化指标和指骨骨密度。结果 CKD患者指骨BMD值与年龄(r=-0.464,P<0.01)、性别(r=-0.287,P<0.05)、血P(r=-0.259,P<0.05)、iPTH(r=-0.315,P<0.01)、β2-MG(r=-0.255,P<0.05)、Hcy(r=-0.264,P<0.05)呈负相关,而与身高、体重、血Ca、ALP、UA无明显相关性;透析年限与指骨BMD(r=-0.568,P<0.01)呈负相关,而与血P(r=0.304,P<0.01)、iPTH(r=0.558,P<0.01)、β2-MG(r=0.540,P<0.01)呈正相关。血液透析组患者指骨BMD低于非透析组和对照组,差异有统计学意义;而非透析组指骨BMD与对照组比较差异无统计学意义。结论血液透析患者指骨BMD较非透析组CKD患者以及健康人群显著下降;血P、iPTH、β2-MG、Hcy水平与指骨BMD相关性好,因此联合检测指骨BMD和血P、iPTH、β2-MG、Hcy水平可能是早期诊断肾性骨病的重要方法。
Objective To investigate the changes of phalangeal bone mineral density (BMD) in patients with chronic kidney disease (CKD) and its relationship with related biochemical markers in order to diagnose early stage of renal osteodystrophy. Methods 75 patients with CKD were divided into dialysis group (38 cases) and non-dialysis group (37 cases). In addition, 30 healthy people were chosen as the control group. Biochemical parameters and phalangeal bone mineral density were measured in 105 subjects. Results The BMD of phalanges in CKD patients were significantly lower than those in controls (r = -0.464, P <0.01), sex (r = -0.287, , P <0.01), β2-MG (r = -0.255, P <0.05), Hcy (r = -0.264, P <0.05), but no significant correlation with height, weight, blood Ca, ALP and UA The dialysis duration was negatively correlated with BMD of phalanges (r = -0.568, P <0.01), but not with the levels of blood P (r = 0.304, P <0.01) r = 0.540, P <0.01). BMD in the hemodialysis group was lower than that in the non-dialysis group and the control group, but there was no significant difference between the non-dialysis group and the control group. Conclusion The BMD of phalanx of hemodialysis patients is significantly lower than that of CKD patients and healthy people in non-dialysis group. The levels of P, iPTH, β2-MG and Hcy in hemodialysis patients are correlated well with phalanges BMD. Therefore, BMD of phalanges and blood P, iPTH, , Hcy levels may be an important method of early diagnosis of renal osteodystrophy.