中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2014年
6期
499-502
,共4页
周娲%薛勤%盛晓华%许涛%程东生%汪年松
週媧%薛勤%盛曉華%許濤%程東生%汪年鬆
주왜%설근%성효화%허도%정동생%왕년송
慢性肾脏病%骨质量%骨钙素N端中分子%β胶原特殊序列%25-羟维生素D
慢性腎髒病%骨質量%骨鈣素N耑中分子%β膠原特殊序列%25-羥維生素D
만성신장병%골질량%골개소N단중분자%β효원특수서렬%25-간유생소D
Chronic kidney disease%Bone quality%Osteocalcin%N-terminus of the molecule%β-collagen special se-quence%25-hydroxyvitamin D
目的:探讨血清骨代谢指标对慢性肾脏病( CKD)患者骨质量好坏的评价意义。方法:收集2012年1月~2013年11月上海市第六人民医院肾内科首次住院的CKD患者95例,将患者按GFR分为CKD3期组、CKD4期组及CKD5期组。测定各组患者血清钙( Ca2+)、磷( P3-)、骨代谢指标碱性磷酸酶( ALP)、骨钙素N端中分子( N-MID)、β胶原特殊序列(β-CTX)、25-羟维生素D[25-(OH)VD]和甲状旁腺激素(PTH)水平。结果:CKD三组患者随着GFR的逐渐下降,血Ca2+、25(OH)D呈下降趋势,血P3-、PTH、N-MID、β-CTX则呈逐渐上升趋势,组间差异有统计学意义(P<0.05);血ALP组间差异总体无统计学意义(P>0.05);Pearson直线相关分析显示GFR分别与血P3-(r=-0.494)、N-MID(r=-0.577)、β-CTX(r=-0.518)呈负相关(P<0.001),与25(OH)D(r=0.289,P=0.008)呈正相关;血P3-与N-MID(r=0.5)、β-CTX(r=0.497)、PTH(r=0.528)分别呈正相关(P<0.001),与25(OH)D呈负相关(r=-0.276,P=0.012);PTH、N-MID、β-CTX三者互为正相关,PTH与N-MID(r=0.532)、PTH与β-CTX(r=0.551)、N-MID与β-CTX(r=0.641)分别呈正相关(P<0.001)。结论:CKD患者血清Ca2+、P3-、PTH、AKP、N-MID、β-CTX、25(OH)D相互作用影响骨质量。血清骨代谢生化指标在评估CKD患者骨质量方面具有重要有益作用。
目的:探討血清骨代謝指標對慢性腎髒病( CKD)患者骨質量好壞的評價意義。方法:收集2012年1月~2013年11月上海市第六人民醫院腎內科首次住院的CKD患者95例,將患者按GFR分為CKD3期組、CKD4期組及CKD5期組。測定各組患者血清鈣( Ca2+)、燐( P3-)、骨代謝指標堿性燐痠酶( ALP)、骨鈣素N耑中分子( N-MID)、β膠原特殊序列(β-CTX)、25-羥維生素D[25-(OH)VD]和甲狀徬腺激素(PTH)水平。結果:CKD三組患者隨著GFR的逐漸下降,血Ca2+、25(OH)D呈下降趨勢,血P3-、PTH、N-MID、β-CTX則呈逐漸上升趨勢,組間差異有統計學意義(P<0.05);血ALP組間差異總體無統計學意義(P>0.05);Pearson直線相關分析顯示GFR分彆與血P3-(r=-0.494)、N-MID(r=-0.577)、β-CTX(r=-0.518)呈負相關(P<0.001),與25(OH)D(r=0.289,P=0.008)呈正相關;血P3-與N-MID(r=0.5)、β-CTX(r=0.497)、PTH(r=0.528)分彆呈正相關(P<0.001),與25(OH)D呈負相關(r=-0.276,P=0.012);PTH、N-MID、β-CTX三者互為正相關,PTH與N-MID(r=0.532)、PTH與β-CTX(r=0.551)、N-MID與β-CTX(r=0.641)分彆呈正相關(P<0.001)。結論:CKD患者血清Ca2+、P3-、PTH、AKP、N-MID、β-CTX、25(OH)D相互作用影響骨質量。血清骨代謝生化指標在評估CKD患者骨質量方麵具有重要有益作用。
목적:탐토혈청골대사지표대만성신장병( CKD)환자골질량호배적평개의의。방법:수집2012년1월~2013년11월상해시제륙인민의원신내과수차주원적CKD환자95례,장환자안GFR분위CKD3기조、CKD4기조급CKD5기조。측정각조환자혈청개( Ca2+)、린( P3-)、골대사지표감성린산매( ALP)、골개소N단중분자( N-MID)、β효원특수서렬(β-CTX)、25-간유생소D[25-(OH)VD]화갑상방선격소(PTH)수평。결과:CKD삼조환자수착GFR적축점하강,혈Ca2+、25(OH)D정하강추세,혈P3-、PTH、N-MID、β-CTX칙정축점상승추세,조간차이유통계학의의(P<0.05);혈ALP조간차이총체무통계학의의(P>0.05);Pearson직선상관분석현시GFR분별여혈P3-(r=-0.494)、N-MID(r=-0.577)、β-CTX(r=-0.518)정부상관(P<0.001),여25(OH)D(r=0.289,P=0.008)정정상관;혈P3-여N-MID(r=0.5)、β-CTX(r=0.497)、PTH(r=0.528)분별정정상관(P<0.001),여25(OH)D정부상관(r=-0.276,P=0.012);PTH、N-MID、β-CTX삼자호위정상관,PTH여N-MID(r=0.532)、PTH여β-CTX(r=0.551)、N-MID여β-CTX(r=0.641)분별정정상관(P<0.001)。결론:CKD환자혈청Ca2+、P3-、PTH、AKP、N-MID、β-CTX、25(OH)D상호작용영향골질량。혈청골대사생화지표재평고CKD환자골질량방면구유중요유익작용。
Objective:To explore the role of serum biochemical markers of bone metabolism in evaluating bone quality of chronic kidney disease( CKD)patients. Nethods:95 patients with CKD from department of Nephrology of the shanghai jiao tong uni-versity affiliated sixth people’s Hospital were collected from January 2012 to November 2013. Patients were divided into stage CKD3, CKD4 and CKD5 group by the GFR. The leves of serum calcium( Ca2+),phosphorus( P3-),serum biochemical markers of bone metabolism such as alkaline phosphatase( ALP),osteocalcin N-terminus of the molecule( N-MID),β-collagen special sequence (β-CTX),25-hydroxyvitamin D[25-(OH)VD],parathyroid hormone(PTH)levels were measured in each group of patients. Results:As the GFR gradually decline,the leves of serum Ca2+,25( OH)D were on the decline,the leves of serum P3-,PTH, N-MID,β-CTX were increased gradually. There were a significant statistical significance difference between the groups( P <0. 05). There was no statistically significant difference of the leves of serum ALP(P>0. 05). Pearson correlation analysis results dis-play:GFR was negatively correlated with serum P3-(r=0. 494),N-MID(r=0. 577),β-CTX correlation(r=0. 518)respec-tively(P<0. 001),and positively correlated with 25(OH)D(r=0. 289,P=0. 008);serum P3- was positively correlated with N-MID(r=0. 5),β-CTX(r=0. 497),PTH(r=0. 528)respectively(P<0. 001),and negatively correlated with 25(OH)D (r=0. 276,P=0. 012);PTH,N-MID,β-CTX mutually positive correlation,PTH and N-MID(r=0. 532),PTH and β-CTX(r=0. 551),N-MID and β-CTX(r=0. 641)were positively correlated(P<0. 001). Conclusion:Serum Ca2+,P3-, PTH,AKP,N-MID,β-CTX,25( OH)D interaction effects bone quality in patients with CKD. Serum biochemical markers of bone metabolism plays a beneficial important role in evaluating bone quality of CKD patients.