CAJ | 학술논문

目的：探讨25-羟基维生素D缺乏的慢性肾功能衰竭（简称慢性肾衰）患者骨代谢平衡的特征及其相互关系。方法检测80例25-羟基维生素 D≤37．5 nmol／L 的慢性肾衰患者及52名健康志愿者（正常对照组，25-羟基维生素 D ＞75．0 nmol／L）外周血骨钙素、总Ⅰ型前胶原氨基末端肽（tP1 NP）、β-异构化的 C-端肽（β-CTx）、甲状旁腺素（PTH）、骨碱性磷酸酶（BAP）、钙、镁、磷、铁水平并对结果进行统计分析。结果25-羟基维生素 D 缺乏的慢性肾衰组 tP1 NP、骨钙素、β-CTx、PTH、磷明显高于正常对照组（P ＜0．01），其余项目两组间差异无统计学意义（P ＞0．05）。25-羟基维生素 D 水平和血钙呈正相关[相关系数（r）＝0．33，P ＜0．05]。结论25-羟基维生素 D 缺乏的慢性肾衰患者的骨代谢特征是以破骨和成骨同时增强的高转换代谢型，对此类患者进行骨转换率的监测比单纯的血钙监测更有意义。
목적：탐토25-간기유생소D결핍적만성신공능쇠갈（간칭만성신쇠）환자골대사평형적특정급기상호관계。방법검측80례25-간기유생소 D≤37．5 nmol／L 적만성신쇠환자급52명건강지원자（정상대조조，25-간기유생소 D ＞75．0 nmol／L）외주혈골개소、총Ⅰ형전효원안기말단태（tP1 NP）、β-이구화적 C-단태（β-CTx）、갑상방선소（PTH）、골감성린산매（BAP）、개、미、린、철수평병대결과진행통계분석。결과25-간기유생소 D 결핍적만성신쇠조 tP1 NP、골개소、β-CTx、PTH、린명현고우정상대조조（P ＜0．01），기여항목량조간차이무통계학의의（P ＞0．05）。25-간기유생소 D 수평화혈개정정상관[상관계수（r）＝0．33，P ＜0．05]。결론25-간기유생소 D 결핍적만성신쇠환자적골대사특정시이파골화성골동시증강적고전환대사형，대차류환자진행골전환솔적감측비단순적혈개감측경유의의。
Objective To investigate the characteristics and relationship of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency.Methods A total of 80 chronic renal failure patients with 25-hydroxy vitamin D≤37.5 nmol/L were enrolled as study group,and 52 healthy subjects with 25-hydroxy vitamin D>75.0 nmol/L were as enrolled as control group.Their peripheral blood osteocalcin,total procollagen type Ⅰ amino terminal peptide (tP1 NP),C-end peptide beta isomerization (β-CTx),parathyroid hormone (PTH),bone alkaline phosphatase (BAP),calcium,magnesium,phosphorus and ferrum were determined.The results were analyzed statistically.Results Compared to control group,tP1 NP,osteocalcin,β-CTx,PTH and phosphorus in study group were higher than those in control group (P <0.01 ).The other parameters had no statistical significance (P >0.05). 25-hydroxy vitamin D levels and calcium were positively correlated [correlation coefficient (r)=0.33,P <0.05 ]. Conclusions The characteristics of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency are enhancing the activity of osteoclasts and bone resorption significantly.It is more important to detect bone turnover rate than calcium in patients with chronic renal failure.