摘要
目的观察血液透析(HD)与腹膜透析(PD)对慢性肾病患者血清甲状旁腺激素(PTH)、骨转运生化相关指标及维生素D水平的影响。方法选取行维持性透析治疗的慢性肾病90例,根据透析方法的不同,分为HD组和PD组,每组各45例。比较血清生化相关指标{钙、磷、全段甲状旁腺激素(iPTH)、骨源性碱性磷酸酶(BALP)、碱性磷酸酶(ALP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、抗酒石酸酸性磷酸酶(TRAP5b)、25-羟基维生素D[25(OH)D]}水平,检测腰椎、股骨颈骨密度,采用Spearman相关性分析观察血清骨转运生化相关指标与腰椎、股骨颈骨密度的相关性。结果与HD组比较,PD组血清β-CTx、TRAP5b水平下降,腰椎及股骨颈T值升高,差异有统计学意义(P<0.05或P<0.01)。Spearman相关性分析显示,两组腰椎及股骨颈T值、Z值与血清iPTH、BALP、ALP、25(OH)D、β-CTx、TRAP5b水平无明显相关性(P>0.05)。结论PD相较于HD治疗慢性肾病能明显降低破骨细胞活性,进而更好地控制骨密度。
Objective To observe the effects of hemodialysis(HD)and peritoneal dialysis(PD)on serum parathyroid hormone(PTH),bone transport-related biochemical indicators and vitamin D level in patients with chronic nephropathy.Methods Ninety patients with chronic nephropathy undergoing maintenance dialysis(MD)were selected and divided into HD group(n=45)and PD group(n=45)according to different dialysis methods.Levels of serum biochemical indicators[calcium,phosphorus,intact parathyroid hormone(iPTH),bone alkaline phosphatase(BALP),alkaline phosphatase(ALP),βC-terminal crosslinked telopeptides of typeⅠcollagen(β-CTx),tartrate-resistant acid phosphatase(TRAP5b)and 25-hydroxyvitamin D[25(OH)D]were compared.Bone density of the lumbar vertebra and femoral neck was detected.Spearman correlation analysis was used to observe the correlation between serum biochemical indicators of bone turnover and bone density of lumbar spine and femoral neck.Results The levels of serumβ-CTx and TRAP5b in PD group were significantly lower than those in HD group,and the lumbar vertebra and femoral neck T values were higher than those of HD group(P<0.05 or P<0.01).Spearman correlation analysis showed that there was no significant correlation of T values and Z values of the lumbar vertebra and femoral neck with levels of serum iPTH,BALP,ALP,25(OH)D,β-CTx and TRAP5b(P>0.05).Conclusion Compared with HD,PD can reduce osteoclast activity and better control bone density in patients with chronic nephropathy.
作者
陈昕
何堤
鲁乃宏
邓莹
CHEN Xin;HE Di;LU Nai-hong;DENG Ying(Department of Nephrology,Hanzhong Central Hospital,Hanzhong,Shaanxi 732000,China)
出处
《临床误诊误治》
2020年第9期77-81,共5页
Clinical Misdiagnosis & Mistherapy
基金
陕西省卫生厅科研基金项目(2016J392741)。
关键词
肾病
慢性
肾透析
腹膜透析
全段甲状旁腺激素
骨源性碱性磷酸酶
骨密度
25-羟维生素D
Nephropathy,chronic
Renal dialysis
Peritoneal dialysis
Intact parathyroid hormone
Bone alkaline phosphatase
Bone density
25-Hydroxyvitamin D
