糖尿病肾功能不全患者骨形成指标的改变  

Changes of Bone Formation Indices in Diabetic Patients with Chronic Renal Insufficiency

作　　者：周江华[1] 陈靖[1] 林善锬[1] 

机构地区：[1]上海医科大学华山医院肾病科,上海200040

出　　处：《上海医科大学学报》2000年第5期368-370,共3页Journal of Fudan University(Medical Science)

基　　金：卫生部基金资助项目!(96-2 -127)

摘　　要：目的　探讨慢性肾功能不全各个阶段糖尿病与非糖尿病患者骨形成指标的异同。方法　采用放免法和常规生化检测法。结果　血浆全段甲状旁腺素水平在非糖尿病肾衰患者中显著升高 ,氮质血症期和尿毒症期分别达到正常值上限的 2倍和 3 .5倍 ;在糖尿病肾衰患者中仅尿毒症期偏高 ,为正常值上限的 1.6倍。血碱性磷酸酶和骨钙素水平也随肾功能减退而上升 ,但糖尿病组和非糖尿病组之间无显著性差异。结论　在慢性肾衰不同阶段 ,糖尿病患者继发性甲状旁腺机能亢进无非糖尿病组显著 。Purpose To investigate the differences of bone formation indices between diabetic and non diabetic patients with various degrees of chronic renal failure(CRF). Methods 171 patients with various degrees of CRF were further divided into diabetic and non diabetic groups. Plasma intact parathyroid hormone (PTH),osteocalcin,alkaline phosphatase(AKP) and other biochemical parameters were detected by radioimmunoassary and roatine laboratory tests. Results Hypocalcemia and hyperphosphatemia only occurred in uremic patients,but no differences were detected between diabetic and non diabetic groups.Plasma intact PTH levels were obviously elevated in non diabetic patients with various degrees of CRF,especially at azotemic and uremic staes,which reached to twice and 3.5 times the upper limit of normal respectively.However in diabetic patients,the intact PTH increment only observed at uremic stage (1.6 times the upper limit of normal),which was markedly lower compared with that in non diabetic patients. Plasma levels of AKP and osteocalcin also increased in CRF patients,but the differences between diabetic and non diabetic groups were not significant. Conclusions During various stages of CRF,diabetic patients did not present obviously secondary hyperparathyroidism,whose bone formation rate seems to be lower compared with that in non diabetic patients.

关 键 词：糖尿病 肾功能不全 甲状旁腺素 骨形成指标 

分 类 号：R587.2[医药卫生—内分泌] R692.5[医药卫生—内科学]