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新近的研究表明肾性骨质病变可发生于肾功能不全的最初阶段。一直指望有一个简便而可靠的方法用以确定代谢性骨病的发生及其程度,从而可有效地进行防治。本文报告各种程度的肾性骨病细微形态学改变与血清碱性磷酸酶骨同功酶活力之间的关系。慢性肾胚疾病患者36例,男17例、女19例,平均年龄43.2±11.3(20～61岁),病程1～7年,其中肾小球肾炎13例,肾畸形或肾周围炎(Paranephritis)15例、多囊肾4例,糖尿病性肾小球硬化症,滥用镇病剂后肾功能衰竭、恶性高血压和病因不明者各1例。另有22例无骨病和肾病的对照者,其余条件基本相似。碱性磷酸酶同功酶测定:血清总碱性磷酸酶正常值<195u/L,骨同功酶正常值<41u/L。骨组织学参数:骨穿刺活检基本作以下测定——骨容积度(VV)、类骨质容积度(V_0)、类骨质表面积分数(OSF)、活性类骨质表面积分数(OASF)、类骨质平均厚度(S)、骨内纤维化表面积分数(EOFS)、骨小梁面与骨小梁容积之比(S/V)、破骨性吸收面积
Recent studies have shown that renal osteoporosis can occur in the initial stages of renal insufficiency. There has long been a count on a simple and reliable method for determining the extent and extent of metabolic bone disease that can be effectively controlled. This article reports the relationship between subtle morphological changes of various degrees of renal osteodystrophy and serum alkaline phosphatase bone isozyme activity. Thirty-six patients with chronic kidney disease, 17 males and 19 females, with an average age of 43.2 ± 11.3 years (range, 20 to 61 years) and a duration of 1 to 7 years, including 13 cases of glomerulonephritis, renal deformity or perinephritis ) In 15 cases, polycystic kidney in 4 cases, diabetic glomerulosclerosis, abuse of antitussive agents after renal failure, malignant hypertension and etiology in 1 case. Another 22 cases without bone disease and kidney disease control, the rest of the conditions were similar. Alkaline phosphatase isoenzyme determination: normal serum total alkaline phosphatase <195u / L, normal bone enzyme <41u / L. Bone histological parameters: The bone biopsy was performed as follows: bone volume (VV), osteoinductivity (V_0), osteoid surface area (OSF), active osteoid surface area fraction (OASF) , Mean osteoid thickness (S), intraosseous fibrosis surface area fraction (EOFS), ratio of trabecular surface to trabecular bone volume (S / V), osteoclastic area