【摘要】目的 观察腹膜透析患者骨密度改变及分析相关因素，为骨质疏松早期诊断和预防骨折发生提供临床依据。方法 选择上海交通大学医学院附属瑞金医院肾内科84例慢性肾衰竭腹膜透析患者，以双能X线吸收 (dual energy X-ray absorptiometry,DEXA)骨密度仪测定腰椎和股骨近端骨密度，同时采集其临床、生化指标及X线平片。结果 11.9%腹膜透析患者骨质疏松，36.9%骨量减少。骨质疏松多元回归分析入选变量为性别、年龄、体质量指数、尿素清除指数（Kt/V）和尿量。这些患者自腹膜透析始骨折总发生率为9.5%。进入骨折Cox回归模型是腰椎Z值和股骨颈Z值及体质量指数。结论 透析不充分、低体质量指数、老年、女性、残余尿量少可能是腹膜透析患者骨质疏松重要危险因素。腰椎和股骨颈Z值可预测腹膜透析患者骨折发生，低体质量指数是腹膜透析患者骨折独立高危因素。

【Abstract】 Objective In order to investigate the determinant factors for bone mineral density (BMD) and the risk factors for osteoporotic fractures in CAPD patients. Methods Eight-four CAPD patients were included in this study. BMD was assessed by dual energy X-ray absorptiometry (DEXA) of lumbar spine and femoral neck. Clinical data and laboratory indices as well as X-ray plain were collected. Results Osteoporosis was found in 11.9% of the 84 patients, and osteopenia in 36.3% patients. Independent variables entering into logistic regression of osteoporosis were sex, age, BMI, Kt/V（P<0.01）and daily urine output (P<0.05). The overall prevalence of fractures since the initiation of peritoneal dialysis was 9.52%. In Cox regression model, fractures were associated with lumbar spine Z-score, femoral neck Z score and BMI. Conclusions Inadequacy of dialysis, low BMI, older age, female and reduced daily urine output may be the important risk factors for osteoporosis in CAPD patients. Lumbar spine and femoral neck Z scores can predict the occurrence of fractures. Among these factors, low BMI is the most important risk factor for fractures in chronic PD patients.