慢性肾脏病患者指骨骨密度与相关生化指标的关系  

Correlation between phalangeal bone mineral density and biochemical parameters in patients with chronic kidney diseases.

作　　者：胡守亮[1] 程骏章[2] 卢宏柱[2] 马特安[2] 姜鸿[2] 雷清凤[2] 吴庆[2] 刘晓[2] 刘俊成[1] 邹启富[2] 

机构地区：[1]长江大学医学院 [2]长江大学附属第一医院肾内科,湖北荆州434000

出　　处：《广东医学》2010年第22期2910-2913,共4页Guangdong Medical Journal

基　　金：湖北省荆州市科技局基金项目(编号:E07-22)

摘　　要：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 change of phalangeal bone mineral density in patients with chronic kidney diseases （CKD） and its relationship with biochemical parameters,for early diagnosis of renal osteodystrophy. Methods Seventy-five patients with CKD were enrolled and assigned into the dialysis group （n=38） and non-dialysis group （n=37）,Thirty health people were included into control group. Biochemical parameters and phalangeal BMD were measured. SPSS software was applied for statistical analysis. Results Phalangeal BMD in patients with CKD were significantly negatively correlated with age （r=-0.464,P〈0.01）,gender （r=-0.287,P〈0.05）,serum P （r=-0.259,P〈0.05）,serum iPTH （r=-0.315,P〈0.01）,serum β2-MG （r=-0.255,P〈0.05） and plasma Hcy （r=-0.264,P〈0.05）,while no significant correlation with height,weight,serum Ca,ALP and UA was found. Dialysis duration was ly negatively correlated with phalangeal BMD （r=-0.568,P〈0.01）,while it was positively correlated with serum P （r=0.304,P〈0.01）,serum iPTH （r=0.558,P〈0.01） and serum β2-MG （r=0.540,P〈0.01）. Phalangeal BMD in hemodialysis patients was significantly lower than those in the other two groups,while there was no significant difference in phalangeal BMD between non-dialysis group and control group. Conclusion Comparing with non-dialysis CKD patients and health people,phalangeal BMD in CKD patients with dialyisis decreases. There are significant correlations between BMD and serum P,serum iPTH,serum β2-MG and plasma Hcy. Combined detection may be important for early diagnosis of osteodystrophy.

关 键 词：慢性肾脏病 骨密度 生化指标 肾性骨病 血液透析 

分 类 号：R459.5[医药卫生—治疗学]