25-羟基维生素D缺乏的慢性肾功能衰竭患者的骨代谢平衡分析  

Analysis of bone metabolism balance in chronic renal failure patients with 25-hydroxy vitamin D deficiency

作　　者：王瑛[1] 沈建雄[1] 徐旻[1] 薛志忠[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《检验医学》2015年第2期149-151,共3页Laboratory Medicine

摘　　要：目的探讨25-羟基维生素D缺乏的慢性肾功能衰竭(简称慢性肾衰)患者骨代谢平衡的特征及其相互关系。方法检测80例25-羟基维生素D≤37.5 nmol/L的慢性肾衰患者及52名健康志愿者(正常对照组,25-羟基维生素D>75.0 nmol/L)外周血骨钙素、总Ⅰ型前胶原氨基末端肽(t P1NP)、β-异构化的C-端肽(β-CTx)、甲状旁腺素(PTH)、骨碱性磷酸酶(BAP)、钙、镁、磷、铁水平并对结果进行统计分析。结果 25-羟基维生素D缺乏的慢性肾衰组t P1NP、骨钙素、β-CTx、PTH、磷明显高于正常对照组(P<0.01),其余项目两组间差异无统计学意义(P>0.05)。25-羟基维生素D水平和血钙呈正相关[相关系数(r)=0.33,P<0.05]。结论 25-羟基维生素D缺乏的慢性肾衰患者的骨代谢特征是以破骨和成骨同时增强的高转换代谢型,对此类患者进行骨转换率的监测比单纯的血钙监测更有意义。Objective To investigate the characteristics and relationship of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency. Methods A total of 80 chronic renal failure patients with25-hydroxy vitamin D≤37. 5 nmol / L were enrolled as study group,and 52 healthy subjects with 25- hydroxy vitamin D〉 75. 0 nmol / L were as enrolled as control group. Their peripheral blood osteocalcin,total procollagen type Ⅰ amino terminal peptide（ t P1NP）,C-end peptide beta isomerization（ β-CTx）,parathyroid hormone（ PTH）,bone alkaline phosphatase（ BAP）, calcium, magnesium, phosphorus and ferrum were determined. The results were analyzed statistically. Results Compared to control group,t P1 NP,osteocalcin,β-CTx,PTH and phosphorus in study group were higher than those in control group（ P〈0. 01）. The other parameters had no statistical significance（ P〉0. 05）.25-hydroxy vitamin D levels and calcium were positively correlated [correlation coefficient（ r） = 0. 33,P〈0. 05].Conclusions The characteristics of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency are enhancing the activity of osteoclasts and bone resorption significantly. It is more important to detect bone turnover rate than calcium in patients with chronic renal failure.

关 键 词：骨代谢 25-羟基维生素D 慢性肾功能衰竭 

分 类 号：R446.1[医药卫生—诊断学]