上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

维持性血液透析患者低骨密度发生及相关因素研究

常安瑾，钱莹，陈晓农，王伟铭，张文，任红，陈楠   

  1. 上海交通大学 医学院附属瑞金医院肾脏科， 上海 200025
  • 出版日期:2016-01-28 发布日期:2016-02-26
  • 通讯作者: 钱莹, 电子信箱: qiany69@163.com。
  • 作者简介:常安瑾（1988—）， 女， 硕士生; 电子信箱: yzchanganjin@126.com。
  • 基金资助:

    国家自然科学基金（81170655）；”十二五”国家科技支撑计划项目（2011BAI10B06）；上海市自然科学基金（14ZR1425400）

Prevalence of low bone mineral density in patients undergoing maintenance hemodialysis and relevant factors

CHANG An-jin, QIAN Ying, CHEN Xiao-nong, WANG Wei-ming, ZHANG Wen, REN Hong, CHEN Nan   

  1. Department of Nephrology, Ruijin Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200025， China
  • Online:2016-01-28 Published:2016-02-26
  • Supported by:

    National Natural Science Foundation of China, 81170655; National Science & Technology Pillar Program in the “12th Five-Year Plan” of China, 2011BAI10B06; Natural Science Foundation of Shanghai, 14ZR1425400。

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摘要：

目的 探讨维持性血液透析（MHD）患者低骨密度（BMD）患病率及相关影响因素。方法 选取2014年4月在上海交通大学医学院附属瑞金医院透析中心接受MHD治疗的患者作为研究对象。采用DEXA骨密度仪测定腰椎及髋部BMD值，分析BMD异常的发生情况；检测血清碱性磷酸酶（AKP）、钙（Ca）、磷（P）、甲状旁腺激素（iPTH）和25-羟基维生素D[25-(OH)D3]水平；分析BMD与临床特征(年龄、性别、体质量指数、透析龄等)和检测指标的相关性。结果 共纳入144例MHD患者，男性85例，女性59例；骨质疏松和骨量减少的发生率分别为19.44%和30.56%；女性骨质疏松发生率（28.8%）明显高于男性（12.9%），差异有统计学意义（P=0.029）。相关性分析结果显示：BMD与体质量指数呈正相关，与透析龄及血清AKP、iPTH水平呈负相关。结论 在积极规范的抗骨质疏松治疗前提下，MHD患者低BMD患病率仍高达50%。性别、透析龄、体质量指数及血清AKP、iPTH水平均与BMD密切相关。

关键词: 骨密度, 维持性血液透析, 骨质疏松

Abstract:

Objective To explore the prevalence of low bone mineral density (BMD) in patients undergoing maintenance hemodialysis (MHD) and relevant influencing factors. Methods A total of 144 patients undergoing MHD in the Hemodialysis Center of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in April, 2014 were enrolled. The BMD values of lumbar spine and hip were measured by the dual energy X-ray absorptiometry (DEXA). Levels of serum alkaline phosphatase (AKP), calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25 hydroxy vitamin D [25 (OH) D3] were detected. Correlations among BMD, clinical characteristics [such as gender, age, body mass index (BMI), and dialysis age], and examination indexes were analyzed. Results Among 144 enrolled patients undergoing MHD, 85 patients were male and 59 patients were female. The prevalence of osteoporosis and osteopenia were 19.44% and 30.56%, respectively. The prevalence of osteoporosis of females (28.8%) was higher than that of males (12.9%) and the difference was statistically significant (P=0.029). Results of correlation analysis showed that BMD positively correlated with BMI and negatively correlated with dialysis age and serum AKP and iPTH levels. Conclusion Based on standardized treatment of osteoporosis, the incidence of low BMD of patients undergoing MHD is still as high as 50%. Gender, dialysis age, BMI, and serum AKP and iPTH levels closely correlate with BMD.

Key words: bone mineral density, maintenance hemodialysis, osteoporosis