中国血液净化

›› 2009, Vol. 8 ›› Issue (2): 76-79.

• 论著 • 上一篇    下一篇

慢性肾脏病患者不同部位骨密度及其与血管钙化的关系

王 宓 王 梅   

  1. 北京大学人民医院肾内科
  • 收稿日期:2009-01-09 修回日期:1900-01-01 出版日期:2009-02-12 发布日期:2009-02-12

Bone mineral density at different sites and its correlation to vascular calcification in chronic kidney disease patients

WANG Mi, WANG Mei   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2009-01-09 Revised:1900-01-01 Online:2009-02-12 Published:2009-02-12

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摘要： 【摘要】 目的 研究慢性肾脏病(CKD)非透析患者不同部位骨密度情况及其与血管钙化的关系。方法 双能X线骨密度仪测定腰椎、股骨及桡骨骨密度，多部位X线平片检测血管钙化情况，检测血肌酐、碱性磷酸酶、钙、磷等生化指标和全段甲状旁腺素(iPTH)水平。40例性别、年龄匹配的健康成人作为骨密度的对照。结果 ①CKD5期非透析患者股骨及桡骨骨密度均明显低于CKD3、4期患者及健康对照者(P＜0.05)，而腰椎骨密度低于CKD3期患者及健康对照者(P＜0.05）。CKD3、4期患者各部位骨密度与健康对照者的差异无统计学意义； ②CKD5期非透析患者股骨骨量异常发生率及桡骨骨质疏松发生率明显高于CKD3期患者及健康对照者(P＜0.05）。3、100例CKD非透析患者中25例(25.0%)有不同程度、不同部位的血管钙化。血管钙化者各部位骨密度均明显低于无钙化者(P＜0.05)。单因素相关分析及Logistic回归显示：三个部位的骨密度中，桡骨T值与血管钙化的关系更为密切。结论 CKD5期非透析患者腰椎、股骨及桡骨骨密度明显降低，CKD3、4期患者骨密度无明显下降，存在血管钙化的患者各部位骨密度降低均更为显著，其中桡骨T值与血管钙化的关系更为密切。

关键词: 慢性肾脏病, 非透析, 骨密度, 血管钙化

Abstract: 【Abstract】 Object To study bone mineral density at different sites and its correlation to vascular calcification in chronic kidney disease (CKD) patients without dialysis treatment. Methods Bone mineral density (BMD) was measured with dual-energy X-ray absorptionmeter. Vascular calcification was quantitatively evaluated by plain radiographic film from abdomen, pelvis and hands. Biochemical parameters and serum intact parathyroid hormone (iPTH) were assayed. Results (a) In CKD patients at stage 5 without dialysis treatment, the BMD at femora and distal radiuses was lower than that in the patients at stages 3 and 4 and in normal controls (P<0.05), and the BMD at lumbar vertebrates was lower than that in patients at stage 3 and in the normal controls (P<0.05). In CKD patients at stages 3 and 4, the BMD at these sites had no significant differences as compared with that of the normal controls. (b) The prevalence of lower BMD at femora and osteoporosis at radiuses was higher in the CKD patients at stage 5 than in those at stage 3 and in normal controls (P<0.05). (c) In the 100 CKD patients without dialysis treatment, 25 cases were found to have various degrees of vascular calcification at different sites. The BMD at lumbar vertebrates, femora and distal radiuses was significantly lower in the patients with vascular calcification than those without the calcification (P<0.05). Logistic regression analysis showed that the lower BMD at radiuses was the independent risk factor for vascular calcification. Conclusion The BMD at lumbar vertebrates, femora and radiuses was significantly decreased in CKD patients without dialysis treatment at stage 5, but not in the patients at stage 3 and stage 4. Patients with vascular calcification were found to have lower BMD. The BMD at radiuses had closer correlation to vascular calcification than that at other sites.

Key words: Pre-dialysis, Bone mineral density, Vascular calcification