无动力性骨病合并尿毒症瘤样钙质沉着症2例及文献复习  

Adynamic bone disease complicated with uraemic tumoral calcinosis:two cases and literature review

作　　者：陈娜 徐甜 刘宏[1] 田娜[2] 张晓良[1] Chen Na;Xu Tian;Liu Hong;Tian Na;Zhang Xiaoliang(Department of Nephrology,ZhongDa Hospital,Institute of Nephrology,School of Medicine,Southeast University,Nanjing 210009,China;Department of Nephrology,General Hospital of Ningxia Medical University,Ningxia Clinical Research Center of Kidney Disease,Yinchuan 750004,China)

机构地区：[1]东南大学附属中大医院肾内科东南大学肾脏病研究所,南京210009 [2]宁夏医科大学总医院肾内科宁夏肾脏病临床研究中心,银川750004

出　　处：《中华肾脏病杂志》2024年第9期741-745,共5页Chinese Journal of Nephrology

基　　金：江苏省社会发展重点研发计划(BE2021737,BE2023770);南京市卫生科技发展专项(YKK21268,YKK20237);宁夏自然科学基金(2021AAC03378)。

摘　　要：无动力性骨病(adynamic bone disease,ABD)是慢性肾脏病-矿物质与骨异常的常见类型,其特点是骨转运和骨重塑降低,临床上低甲状旁腺素(parathyroid hormone,PTH)血症是其重要特征。瘤样钙质沉着症(tumoral calcinosis,TC)是一种表现为软组织和关节周围结构广泛钙化的罕见良性病变,但其确切发病机制尚不清楚。尿毒症瘤样钙质沉着症(uraemic tumoral calcinosis,UTC)在透析患者中虽然发生率较低,但对患者的生活质量、预后会带来严重的不利影响。该文报道了2例ABD合并UTC患者,其中1例患者TC累及双手、双足、双肩胛骨、胸锁关节、髂骨、股骨头、骶尾部,另1例患者TC累及左肩。经重组人PTH特立帕肽注射液皮下注射、硫代硫酸钠静滴、降磷、充分透析等治疗,患者好转。Adynamic bone disease(ABD)is a common type of chronic kidney disease-mineral and bone disorder(CKD-MBD).It is characterized by decreased bone transport and bone remodeling.Clinically,low parathyroid hormone(PTH)is an important feature of ABD.Tumoral calcinosis(TC)is a rare benign lesion characterized by extensive calcification of soft tissue and periarticular structures,but its exact pathogenesis is still unclear.Although the incidence of uremic tumoral calcinosis(UTC)in dialysis patients is low,it has a serious adverse impact on the quality of life and prognosis of patients.This paper reports two patients with ABD complicated with UTC.One patient had TC involving both hands,both feet,both scapulae,sternoclavicular joint,ilium,femoral head and sacrococcygeal region,and the other patient had TC involving the left shoulder.After treatment with recombinant human PTH teriparatide injection,sodium thiosulfate,phosphorus reduction,and full dialysis,the patients'condition improved.

关 键 词：特立帕肽 尿毒症 甲状旁腺素 钙质沉着症 无动力性骨病 瘤样钙质沉着症 

分 类 号：R692.5[医药卫生—泌尿科学] R681[医药卫生—外科学]