维持性血液透析患者骨质疏松的患病情况及危险因素  

The incidence and risk factors of osteoporosis in maintenance hemodialysis patients of one center

作　　者：杨文领[1] 朱宁[1] 郑丹侠[1] 阿拉塔[1] 

机构地区：[1]北京大学第三医院肾内科,北京100191

出　　处：《中国骨质疏松杂志》2008年第11期808-813,共6页Chinese Journal of Osteoporosis

摘　　要：目的分析维持性血液透析患者骨质疏松的患病情况及危险因素。方法入组的稳定血液透析患者52例,男27例(占51.9%),测定其血清全段甲状旁腺激素(iPTH)、钙、磷、钙磷乘积及骨密度等,分析骨密度的可能危险因素。结果骨量丢失者21例(占40.4%),骨质疏松者13例(占25.0%),其中女性占所有骨质疏松者的92.3%;多元线性回归分析显示非透析人群中的传统危险因素如干体重、糖尿病、碱性磷酸酶等多种因素均与骨密度相关,而iPTH尽管是调节钙磷代谢的重要因子,多元回归分析显示iPTH并不与骨密度相关。结论在维持性血液透析患者中骨质疏松是个较为严重的问题,传统因素如干体重低、糖尿病等均是骨质疏松的危险因素,碱性磷酸酶高者骨密度低,而iPTH并不是骨密度的独立危险因素。Objective To learn about the incidence and risk factors of osteoporosis in the maintenance hemodialysis patients. Methods There were 52 stable maintenance hemodialysis patients enrolled in the study with 27 male. The serum iPTH, calcium, phosphate level, bone mineral density（BMD） were measured and the risk factors of osteoporosis were analyzed. Results The bone mineral density examination demonstrated that the percentage of osteoporosis was 25.0% and that of osteopenia was 40.4%. 92.3% osteoporosis patients were female. The traditional risk factors in nondialystie patients such as dry weight, diabetes mellitus, ALP and so on were also important factors that influenced the bone mineral density of hemodialysis patients. Although iPTH influence the metabolism of calcium and phosphus, it wasn＇t an independent risk factor of bone mineral density. Conclusion The osteoporosis are very common in maintenance hemodialysis patients. The traditional risk factors in nondialystie patients such as dry weight, diabetes mellitus and so on were also important factors in hemodialysis patients. Those with high serum ALP have low bone mineral density, iPTH wasn＇t an independent risk factor of bone mineral density.

关 键 词：血液透析 骨质疏松 甲状旁腺激素 

分 类 号：R459.5[医药卫生—治疗学]