慢性肾功能衰竭中晚期骨密度与骨代谢生化指标的相关性  

The correlation between bone mineral density and biochemical markers of bone metabolism in the patient with advanced chronic renal failure

作　　者：薛增奇[1] 陈金春[1] 黄建华[1] 缪初升[1] 陈法东[1] 林爱菊[1] 

机构地区：[1]浙江省温州医学院附属第三医院,浙江瑞安325200

出　　处：《中医正骨》2009年第2期7-10,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:研究慢性肾功能衰竭(CRF)中晚期患者骨密度与骨代谢生化指标的相关性,探讨肾性骨质疏松症的发病机制。方法:选择124例CRF中晚期患者按肌酐清除率(Ccr)分Ⅲ期、Ⅳ期、Ⅴ期三组;检测患者的肾功能、骨代谢生化指标,用双能骨密度仪检测其骨密度,分析三组骨质疏松的发生率,骨代谢生化指标、骨密度T值间的差异及两者间的相关性,并进行统计分析。结果:三组间Ccr、BGP、P、PTH、骨密度T值间差异有统计学意义(P<0.05),而Ca、ALP差异无统计学意义(P>0.05)。三组骨质疏松的发生率分别为10.71%、30.95%、69.23%,三者间比较差异有统计学意义(P<0.05)。骨密度与Ccr呈正相关,与PTH呈负相关,与Ca和ALP值不存在相关性。结论:慢性肾衰竭中晚期骨质疏松症的发生与Ccr、BGP、P、PTH值有明显的相关性,与Ca、ALP值不存在相关性,随着肾功能衰竭程度的加重,骨质疏松症的发病率随之增加。Objective：To study the correlation between bone mineral density and biochemical markers of bone metabolism in the patients with advanced chronic renal failure, and investigate the pathogenesis of kidney osteoporosis. Methods ：124 patients with advanced CRF were divided into three groups according to creatinine clearance （Ccr）. They were III period, IV period and Vperiod respectively. Renal function, biochemical markers of bone metabolism and bone mineral density（by dual-energy instrument）were detected in those patients. The incidence of osteoporosis,biochemical markers of bone metabolism and T value of bone mineral density were compared among those three groups, and the corelation of later two factors were analyzed too. Result： There were significant differences on Ccr, BGP. P, PTH and T value of bone mineral density among three groups （P 〈 0.05 ）. While there had no significant difference in Ca and ALP （P 〉 0.05 ）. The incidence of osteoporosis were respectively 10.71%, 30.95 % and 69.23 %, and statistically significant differences was found （ P 〈 0.05 ）. There was a positive correlation between bone mineral density with Ccr （ r = 0. 881 ,P =0. 000） ,but a negative correlation with BGP,P and PTH（r =0. 932,P =0. 000;r =0. 781 ,P =0. 000;r = - 0. 813 ,P = 0. 000） , and no correlation between with ALP and Ca （ r = 0. 105. P = 0. 248 ： r = 0. 094, P = 0. 297 ）. Conclusion：Researches Showed that in the patients with advanced CRF. there had obvious correlation between the incidence of osteoporosis with Ccr, BGP, P and PTH. but no correlation with Ca and ALP. The incidence of osteoporosis raised with increase of the severity of CRF.

关 键 词：肾功能衰竭 慢性 骨密度 骨代谢生化指标 相关性 临床研究 

分 类 号：R692.5[医药卫生—泌尿科学] R580[医药卫生—外科学]