雌激素对维持性血透妇女患者骨质疏松的影响  

Effect of estrogen on pathogenesis of osteoporosis in women with maintenance hemodialysis

作　　者：商华[1] 尹友生[1] 李小励[1] 何涌[2] 邱维加[2] 邓一岚[1] 李小红[1] 李康慧[1] 

机构地区：[1]桂林医学院附属医院肾内科,541001 [2]桂林医学院附属医院放射科,541001

出　　处：《中华内分泌代谢杂志》2010年第2期108-110,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：探讨雌激素水平在维持性血透（MHD）妇女骨质疏松发生中的作用。选择年龄18—45岁的妇女120例，其中MHD（〉13个月）妇女60例为对照组，MHD（≥3个月）且罹患骨质疏松60例妇女为观察组。两组研究对象均检测血浆雌二醇、肿瘤坏死因子仪（TNF—α）、甲状旁腺素（PTH）及血钙水平，同时用定量CT法（QCT）测定骨密度。观察组雌二醇水平低于对照组（P〈0．05），TNF-α水平观察组高于对照组（P〈0．05），PTH和血钙水平两组间无显著差异（P=0．567和P=0．588）；直线相关分析示，观察组雌二醇与骨密度呈正相关（r=0．865，P〈0．01）；观察组经多元线性回归分析示，雌二醇、血钙浓度与骨密度值呈正相关、TNF-α、PTH与骨密度呈负相关（F=140．32，P〈0．01），且雌二醇对骨密度的影响较大（t=5．386，P〈0．01）。血浆低雌激素水平是MHD妇女骨质疏松发生的一个主要因素，且可以通过调节TNF—α水平而促进骨质疏松的发生。[ Summary] To explore the effect of estrogen on pathogenesis of osteoporosis in women with maintenance hemodialysis. One hundred and twenty women aged 18-45 years had been undergoing maintenance hemodialysis for ≥ 3 months were included. Of them,60 women without osteoporosis served as control group and the other 60 women with osteoporosis as observation group. Serum concentrations of estradiol, tumour necrosis factor-α （ TNF-α ） , parathyroid hormone （PTH）, and calcium were determined, meanwhile bone mineral density （BMD）was measured by quantitative computed tomography. Serum estradiol levels in the observation group were lower while TNF-α level were higher than those in control group （all P〈0.05 ）. PTH and calcium levels were not significantly different （P= 0. 567 and P = 0. 588 ）. In the observation group, linear correlation analysis revealed positive correlation （r = 0. 865 ,P〈0.01 ）between estradiol and BMD ,while multiple linear regression analysis showed that serum estradiol and calcium levels were positively correlated with BMD, and the concentrations of TNF-α and PTH were negatively correlated with BMD （F = 140.32,P〈0.01 ）. Estradiol levels were found to have greater effect on BMD （t = 5. 386, P〈0.01 ）. Lowered serum concentration of estradiol in women with maintenance hemodialysis seems to be a major factor related to osteoporosis,it accelerates the pathogenesis of osteoporosis by modulating TNF-α.

关 键 词：雌激素 维持性血透 骨质疏松 

分 类 号：R580[医药卫生—内分泌] R692.5[医药卫生—内科学]