【摘要】 目的：观察不同肾功能状态时慢性肾脏病患者的骨代谢状况。方法：采用酶联免疫法和放射免疫法检测６０名不同肾功能状态的慢性肾脏病患者和４５名正常人的骨吸收指标——尿脱氧吡啶酚（ＤＰＤ）、尿钙／肌酐（Ｃａ／Ｃｒ）比值、血中段甲状旁腺素（Ｍ－ＰＴＨ）和骨形成指标——血骨钙素（ＢＧＰ）、碱性磷酸酶（ＡＬＰ）。同时，以双能Ｘ线吸收法（ＤＥＸＡ）检测腰椎（Ｌ２～４）、股骨颈、ＷＡＲＤＳ三角和股骨粗隆部位的骨密度。结果：正常人随年龄的增长，尿ＤＰＤ排泄增多，尿Ｃａ／Ｃｒ比值、血Ｍ－ＰＴＨ、ＢＧＰ也相应升高。４０岁以后，Ｌ２～４及股骨各部位的骨密度逐渐下降。在年龄段相等时，慢性肾脏病患者，即使是肾功能正常者，也存在有骨代谢的异常，表现为骨吸收与骨形成的增强。随着肾功能的恶化，这种异常表现更为突出，而且还出现了骨密度的改变。结论：骨代谢的改变与骨密度的下降与肾脏病变性质及肾功能状态有明显的关系更多还原

【Abstract】 OBJECTIVE To define the influence of chronic renal diseases on bone turnover. METHODOLOGY 60 patients with various chronic renal diseases were studied. 30 Patients had increased serum creatinine level. Markers for bone resorption, including urine deoxypyridinoline and calcium, serum middle weight PTH level were measured. The indexes for bone formation were the serum levels of osteocalcin and alkaline phosphatase. Bone mineral density was measured by DEXA. RESULTS Patients with chronic renal diseases had increased urine calcium and deoxypyridinoline excretion as compared with 45 age and sex matched normal controls. The increase of urine deoxypyridinoline excretion was more marked in patients with increased serum creatinine than patients with normal serum creatinine. In addition, patients with renal insufficiency had increased serum middle weight PTH levels. Serum osteocalcin and alkaline phosphatase levels were also increased in patients with renal diseases. While the bone mineral density was significantly decreased, especially in patients with renal insufficiency, compared with normal controls. CONCLUSION Patients with chronic renal diseases had increased bone turnover, especially in patients with renal insufficiency.更多还原