肾病患者骨代谢指标变化的研究  

Study on the index changes of bone metabolism in patients with nephropathy

作　　者：洪宝建[1] 苏丽韫[1] 梁丽娟[1] 朱月霞[1] 徐柯[1] 边平达[2] 

机构地区：[1]浙江省人民医院检验中心,浙江杭州310024 [2]浙江省人民医院内科,浙江杭州310024

出　　处：《中国卫生检验杂志》2016年第2期244-246,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的研究不同阶段肾病患者骨密度及骨代谢指标的变化。方法检测肾病患者与正常同龄人的骨密度(BMD)和骨代谢等生化指标,并进行比对分析。结果与正常对照组比较,急性肾病组血钙(Ca)、25-OH维生素D3(25-OH-D3)降低,血磷(P)、甲状旁腺素(TPH)升高,差异有统计学意义(P<0.05)。与正常对照组比较,慢性肾病组和肾衰组血Ca、25-OH-D3均降低,血P、TPH、骨钙素(OCN)、总Ⅰ型胶原氨基端前肽(T1NP)、Ⅰ型胶原羧基端肽特殊序列(CTx)均升高,差异有统计学意义(P<0.05);慢性肾病组与肾衰组比较:肾衰组Ca、T1NP、TPH、BMD降低,血P增高,差异有统计学意义(P<0.05)。结论骨代谢指标较BMD能更敏感反映肾病早期骨代谢的变化,是肾病患者骨质疏松预防与疗效观察的良好指标。Objective To study the changes of bone mineral density（ BMD） and bone metabolism indexes in patients with nephropathy at different stages. Methods The BMD and bone metabolism indexes of patients with nephropathy were determined,and compared with that of control group. Results In the acute kidney disease group,the serum levels of calcium（ Ca） and25- hydroxyvitamin D3（ 25- OH- D3） were significantly lower than that in the control group,while the serum concentrations of phosphate（ P） and parathyroid hormone（ PTH） were higher than that in the control group,and the difference was statistically significant（ P〈 0. 05）. In the chronic kidney disease and renal failure group,the serum levels of Ca and 25- OH- D3 were significantly lower than that in the control group,while the serum levels of P,osteocalcin（ OCN）,total procollagen type I amino-terminal propeptide（ T1NP）,β- C- terminal telopeptides of type I collagen（ CTx） were all higher than that in the control group,and the difference was statistically significant（ P 〈0. 05）. Compared with the chronic kidney disease（ CKD） with the renal failure group： in the renal failure group,Ca,T1 NP,TPH,BMD decreased,while serum P increased,and the difference was statistically significant（ P〈0. 05）. Conclusion Bone metabolism indexes are more sensitive than BMD to reflect the alterations of bone metabolism in patients with early stage nephropathy,and it is a good indicator of osteoporosis prevention and curative effect observation in patients with renal disease.

关 键 词：肾病 骨密度 骨代谢指标 

分 类 号：R692.5[医药卫生—泌尿科学]