CAJ | 학술논문

探讨雌激素水平在维持性血透(MHD)妇女骨质疏松发生中的作用.选择年龄18～45岁的妇女120例,其中MHD(≥3个月)妇女60例为对照组,MHD(≥3个月)且罹患骨质疏松60例妇女为观察组.两组研究对象均检测血浆雌二醇、肿瘤坏死因子α(TNF-α)、甲状旁腺素(PTH)及血钙水平,同时用定量CT法(QCT)测定骨密度.观察组雌二醇水平低于对照组(P<0.05),TNF-α水平观察组高于对照组(P<0.05),PTH和血钙水平两组间无显著差异(P=0.567和P=0.588);直线相关分析示,观察组雌二醇与骨密度呈正相关(r=0.865,P<0.01);观察组经多元线性回归分析示,雌二醇、血钙浓度与骨密度值呈正相关、TNF-α、PTH与骨密度呈负相关(F=140.32,P<0.01),且雌二醇对骨密度的影响较大(t=5.386,P<0.01).血浆低雌激素水平是MHD妇女骨质疏松发生的一个主要因素,且可以通过调节TNF-α水平而促进骨质疏松的发生.
탐토자격소수평재유지성혈투(MHD)부녀골질소송발생중적작용.선택년령18～45세적부녀120례,기중MHD(≥3개월)부녀60례위대조조,MHD(≥3개월)차리환골질소송60례부녀위관찰조.량조연구대상균검측혈장자이순、종류배사인자α(TNF-α)、갑상방선소(PTH)급혈개수평,동시용정량CT법(QCT)측정골밀도.관찰조자이순수평저우대조조(P<0.05),TNF-α수평관찰조고우대조조(P<0.05),PTH화혈개수평량조간무현저차이(P=0.567화P=0.588);직선상관분석시,관찰조자이순여골밀도정정상관(r=0.865,P<0.01);관찰조경다원선성회귀분석시,자이순、혈개농도여골밀도치정정상관、TNF-α、PTH여골밀도정부상관(F=140.32,P<0.01),차자이순대골밀도적영향교대(t=5.386,P<0.01).혈장저자격소수평시MHD부녀골질소송발생적일개주요인소,차가이통과조절TNF-α수평이촉진골질소송적발생.
To explore the effect of estrogen on pathogenesis of osteoporosis in women with maintenance hemodialysis. One hundred and twenty women aged 18-45 years had been undergoing maintenance hemodialysis for ≥ 3 months were included. Of them ,60 women without osteoporosis served as control group and the other 60 women with osteoporosis as observation group. Serum concentrations of estradiol, tumour necrosis factor-α (TNF-α), parathyroid hormone (PTH), and calcium were determined, meanwhile bone mineral density (BMD)was measured by quantitative computed tomography. Serum estradiol levels in the observation group were lower while TNF-α level were higher than those in control group (all P<0. 05). PTH and calcium levels were not significantly different (P= 0.567 and P = 0. 588). In the observation group, linear correlation analysis revealed positive correlation (r = 0. 865 ,P<0. 01)between estradioi and BMD,while multiple linear regression analysis showed that serum estradiol and calcium levels were positively correlated with BMD, and the concentrations of TNF-α and PTH were negatively correlated with BMD (F= 140.32 ,P<0.01). Estradiol levels were found to have greater effect on BMD(t=5. 386, P<0. 01). Lowered serum concentration of estradiol in women with maintenance hemedialysis seems to be a major factor related to osteoporosis,it accelerates the pathogenesis of osteoporosis by modulating TNF-α.