老年维持性血液透析患者骨密度改变临床研究  

Changes of bone mineral density in elderly maintenance hemodialysis patients

作　　者：张冬[1] 孙雪峰[1] 朱晗玉[1] 马志芳[1] 陈香美[1] 

机构地区：[1]解放军总医院肾病科解放军肾脏病中心暨重点实验室,北京市100853

出　　处：《中华实用诊断与治疗杂志》2011年第4期321-323,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家973项目(2007CB507400);国家自然科学基金面上项目(30871171);全军医学科研"十一五"专项基金(08Z034)

摘　　要：目的:探讨老年维持性血液透析患者骨密度变化特点。方法:维持性血液透析老年患者40例为透析组,同期老年健康体检者40例为对照组。采用双能X线骨密度仪测量2组腰椎(L1-4)及左侧股骨骨密度,同时检测2组血钙、血磷及透析组甲状旁腺素等指标。结果:血液透析患者股骨颈骨密度及股骨大转子密度均低于对照组(P<0.05),而腰椎骨密度比较差异无统计学意义(P>0.05);透析组血钙及血磷浓度以及及骨折发生率均高于对照组(P<0.05);透析组中骨质疏松患者透析时间较非骨质疏松患者长(P<0.05),血钙、血磷高于非骨质疏松者(P<0.05),甲状旁腺素水平较非骨质疏松者低(P<0.05)。结论:老年维持性血液透析患者骨密度下降以皮质骨明显,多不伴有低钙血症但甲状旁腺素水平偏低。Objective To investigate the features of the change of bone mineral density in elderly maintenance hemodialysis patients.Methods Forty elderly maintenance hemodialysis patients（hemodialysis group） and forty normal controls（control group） were collected blood calcium,phosphorus and plasma immunoreactive parathyroid hormone,and the elderly maintenance hemodialysis patients were assessed bone mineral density with dual energy X-ray absorptiometry of lumbar spine and femoral neck.Results The levels of bone mineral density of femoral neck and greater trochanter were significantly lower in maintenance hemodialysis patients than those in control group（P0.05）,and there was no significant difference in bone mineral density of lumbar spine between two groups（P0.05）.The levels of plasma calcium and phosphorus were higher in maintenance hemodialysis patients than those in control group（P0.05）.The hemodialysis duration was longer in the maintenance hemodialysis patients complicated with osteoporosis than that in patients not complicated with osteoporosis（P0.05）,and the level of plasma immunoreactive parathyroid hormone was lower in the patients with osteoporosis（P0.05）.Conclusion The decrease of bone mineral density is the most obvious in cortical bone in the elderly maintenance hemodialysis patients,and more patients are complicated with lower plasma immunoreactive parathyroid hormone but not hypocalcemia.

关 键 词：维持性血液透析 骨密度 老年 

分 类 号：R692.5[医药卫生—泌尿科学]