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目的对维持性血液透析(maintenance hemodialysis,MHD)患者骨密度情况及相关代谢指标进行测定研究,了解骨质疏松患病情况及其相关生化指标变化,拟确定一项能够明确反应骨量的简单易行的监测方法。方法选择常州市第一人民医院血液净化中心106例MHD患者作为试验对象,采用双能X线骨密度仪测量所有样本的第1~4腰椎及骨盆骨密度(Bone mineral density,BMD)等指标,记录患者的年龄、性别、身高、体质量、骨折等资料,同时进行相关代谢指标监测。用Graph Pad Prism5软件进行统计学分析。结果维持性透析患者骨质疏松患病高达35.85%,碱性磷酸酶(ALP)和PTH高度正相关,ALP和PTH与BMD均存在明显负相关;BMI与BMD呈正相关,而年龄、性别、透析龄与BMD无相关性。结论MHD患者与其他人群相比骨质疏松患病率高,患病情况更严重且更易发生骨折;ALP及PTH可作为骨量的临床监测指标,ALP及PTH明显升高者应行BMD检查;负重运动及体育锻炼有利于增强骨密度。
OBJECTIVE To study the bone mineral density (BMD) and related metabolic parameters in patients with maintenance hemodialysis (MHD) and to understand the prevalence of osteoporosis and the related biochemical parameters. To determine a simple and easy to understand bone mass Bank monitoring methods. Methods A total of 106 patients with MHD from the First People’s Hospital of Changzhou, China, were enrolled in this study. Bone mineral density (BMD) indexes of lumbar spine and pelvis from 1 to 4 were measured by dual energy X-ray absorptiometry. Record the patient’s age, gender, height, body mass, fractures and other data, at the same time, the relevant metabolic indicators monitoring. Statistical analysis was performed using Graph Pad Prism 5 software. Results The prevalence of osteoporosis in maintenance hemodialysis patients was 35.85%. Alkaline phosphatase (ALP) was positively correlated with PTH. ALP and PTH were negatively correlated with BMD. BMI was positively correlated with BMD, while age, gender, There was no correlation between BMD and age. Conclusion The prevalence of osteoporosis is higher in patients with MHD compared with other groups. The prevalence is more serious and the fractures are more likely to occur. ALP and PTH may be used as clinical monitoring indexes of bone mass. BMD should be performed in patients with obvious elevation of ALP and PTH. Weight-bearing exercise and physical activity are beneficial to increase bone density.