CAJ | 학술논문

目的：通过单侧肾切除加高磷饲料喂养大鼠建立大鼠继发性甲状旁腺功能亢进症骨病动物模型，观察甲状旁腺功能亢进症对全身骨质改变状况的影响。方法8~10周龄雄性SD大鼠80只，体质量175~200 g，随机分为四组：假手术正常磷饮食（ SH＋NP）组20只，手术正常磷饮食（ ST＋NP）组20只，手术高磷饮食（ ST＋HP）组20只，假手术高磷饮食（SH＋HP）组20只。造模术后第1、2、4、8周，检测血清肌酐（SCr）、磷（P）、钙（Ca）、1，25-二羟维生素D3[1，25（OH）2D3]、全段甲状旁腺激素（iPTH）水平，以及X线、骨密度。结果①单侧肾切除组术后各时段血清SCr和iPTH水平均高于假手术组（P﹤0.05）；同时ST＋HP组4、8周后血清SCr水平均明显高于ST＋NP组（P﹤0.05），且ST＋HP组各时段血清iPTH水平均明显高于ST＋NP组（P﹤0.05）；ST＋HP组术后各时段血清P水平高于SH＋HP组（ P﹤0.05）。②ST＋HP组骨质疏松7例，骨吸收6例，骨硬化2例，转移性钙化3例。③ST＋HP组股骨骨密度、股骨抗弯力和全身骨密度明显低于SH＋NP组（P﹤0.05，P﹤0.01）。结论本研究成功建立了继发性甲状旁腺功能亢进骨病的大鼠模型，为进一步研究肾性继发性甲状旁腺功能亢进骨病奠定了实验基础。
목적：통과단측신절제가고린사료위양대서건립대서계발성갑상방선공능항진증골병동물모형，관찰갑상방선공능항진증대전신골질개변상황적영향。방법8~10주령웅성SD대서80지，체질량175~200 g，수궤분위사조：가수술정상린음식（ SH＋NP）조20지，수술정상린음식（ ST＋NP）조20지，수술고린음식（ ST＋HP）조20지，가수술고린음식（SH＋HP）조20지。조모술후제1、2、4、8주，검측혈청기항（SCr）、린（P）、개（Ca）、1，25-이간유생소D3[1，25（OH）2D3]、전단갑상방선격소（iPTH）수평，이급X선、골밀도。결과①단측신절제조술후각시단혈청SCr화iPTH수평균고우가수술조（P﹤0.05）；동시ST＋HP조4、8주후혈청SCr수평균명현고우ST＋NP조（P﹤0.05），차ST＋HP조각시단혈청iPTH수평균명현고우ST＋NP조（P﹤0.05）；ST＋HP조술후각시단혈청P수평고우SH＋HP조（ P﹤0.05）。②ST＋HP조골질소송7례，골흡수6례，골경화2례，전이성개화3례。③ST＋HP조고골골밀도、고골항만력화전신골밀도명현저우SH＋NP조（P﹤0.05，P﹤0.01）。결론본연구성공건립료계발성갑상방선공능항진골병적대서모형，위진일보연구신성계발성갑상방선공능항진골병전정료실험기출。
Objective To establish a rat hyperparathyroidism osteopathy model,and observe the impact on the change of whole body bone. Methods Eighty male SD rats,weighing 175-200 g,were randomly divided into 4 groups:nephrectomy plus high phosphorus food( ST+HP)group,nephrectomy plus normal phosphorus food( ST +NP)group,sham operation plus high phosphorus food( SH +HP) group,and sham operation plus normal phosphorus food( SH+NP)group. Serum phosphorus,SCr,P, Ca,1,25(OH)2D3,iPTH levels,X-ray and bone mineral density were detected at the 1sh,2ed,4th and 8th week after the operation. Results Serum SCr and iPTH levels of nephrectomy groups at dif-ferent time points after operation were higher than those before operation and those of sham operation groups(P﹤0. 05). Serum SCr(4,8 weeks)and iPTH level of ST+HP group was obviously higher than that of ST + NP group( P ﹤0. 05 );Serum phosphorus level of ST+HP group was obviously higher than that of SH + HP group( P﹤0. 05 ). Osteoporosis of ST+HP group was 7 cases,bone resorption in 6 cases,bone sclerosis in 2 cases,and metastatic calcification in 3 cases. BMD level, femoral bending force and the level of the whole body bone mineral density of ST +HP group were lower than those of SH+NP group( P ﹤0. 05 ,P ﹤0. 01 ). Conclusions Nephrectomy plus high phosphorus foods can be used to establish hyperparathyroidism model secondary to chronic renal fail-ure in rats.