维持性血液透析患者骨质疏松的危险因素分析  

Analysis on the factors related to osteoporosis in maintenance hemodialysis patients

作　　者：张瑜凌 王梦婧[1] 张敏敏[1] 张倩[1] 黄碧红[1] 陶艳菊[1] 姚瑶[1] 陈靖[1] 

机构地区：[1]复旦大学附属华山医院肾脏科,上海200040

出　　处：《中华肾脏病杂志》2016年第4期259-263,共5页Chinese Journal of Nephrology

基　　金：国家自然科学基金（81170684）;上海市优秀学科带头人培养计划（XBR2013080）

摘　　要：目的评估维持性血液透析（MHD）患者骨质疏松的发生率，分析MHD患者发生骨质疏松的危险因素。方法人选83例MHD患者和87例健康者，采用双能x线骨密度仪测定股骨近端骨密度，比较MHD组患者和正常对照组人群骨密度。同时记录MHD组患者年龄、透析龄、身高、体重、步行运动量、用药、饮食等资料，检测骨代谢相关指标，比较不同骨密度组患者一般情况及骨代谢相关指标差异。以骨密度T值为因变量，行多因素回归分析。结果MHD患者骨质疏松发生率明显高于健康对照组（34．9％比20．7％，P〈0．05）。骨质疏松组绝经妇女比例明显高于骨量正常或减少组；步行运动量、体重明显少于骨量正常或减少组（均P〈0．05）。多元回归分析结果显示年龄（β=-0．02，P=0．011）、体重（β=0．02，P=0．031）、步行运动量（β=0．13，P=0．027）是MHD患者骨密度的相关因素。结论MHD患者骨质疏松发生率明显高于健康人群，高龄、低体重、运动量少是MHD患者骨质疏松的独立危险因素。Objective To evaluate the prevalence of osteoporosis in maintenance hemodialysis（MHD） patients and analyze the risk factors. Methods Eighty-three patients on MHD and 87 healthy people were recruited, measuring and comparing their mineral density of femoral bone. Patients＇ age, sex, height, body weight, walking activity, medication use and laboratary tests were recorded. The relationship of bone mineral density （BMD） and other factors were analyzed using multivariate linear regression. Result The prevalence of osteoporosis was higher in MHD patients than in normal control （34.7% vs 20.7%, P 〈 0.05）. Patients in osteoporosis gro,p showed higher rate of menopause, lower body weight and lower walking activity. In muhivariable regression model, age （β=-0.02, P=0.011）, body weight （β=0.02, P=0.031） and walking activity （β=0.13, P=0.027） were independently associated with BMD in MHD patients. Conclusion The prevalence of osteoporosis is much higher in MHD patients than in healthy people. Advanced age, low body weight and inactivity are important risk factors for osteoporosis in MHD patients.

关 键 词：肾透析 骨质疏松 年龄因素 体重 运动 

分 类 号：R459.5[医药卫生—治疗学]