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目的观察维持性血液透析患者骨质疏松现状,研究骨密度及骨代谢指标间关系,讨论影响骨质疏松的危险因素。方法选取维持性血液透析患者125例,收集一般资料及透析相关信息,检测25羟维生素D,骨源性碱性磷酸酶,跟骨骨密度,进行横断面研究。应用SPSS19.0软件,P<0.05为差异有统计学意义。结果维持性血液透析患者骨质疏松发生率为48%,25羟维生素D缺乏为30.4%。不同性别间骨质疏松患病率差异无统计学意义。绝经女性骨密度显著低于未绝经女性(P<0.001)。女性25羟维生素D水平显著低于男性(P=0.026)。肾小管间质性疾病者骨密度明显低于慢性肾小球肾炎者(P=0.001)。不运动者骨密度明显低于运动者(P<0.001)。骨密度与年龄,透析龄显著负相关(r=-0.387,P<0.001,r=-0.190 P=0.034)。老龄、绝经、轻体重、不运动、肾移植是维持性透析患者骨质疏松的危险因素。结论维持性血液透析患者骨质疏松和25羟维生素D缺乏发生率高,但二者间无相关性。老龄、绝经、轻体重、不运动、肾移植后应用激素及免疫抑制剂是终末期肾病维持性透析患者骨质疏松的危险因素。
Objective To observe the status of osteoporosis in maintenance hemodialysis patients, study the relationship between bone mineral density and bone metabolism index, and to discuss the risk factors affecting osteoporosis. Methods A total of 125 patients with maintenance hemodialysis were enrolled in this study. General information and dialysis-related information were collected. 25-hydroxyvitamin D, bone alkaline phosphatase and calcaneal bone mineral density were collected for cross-sectional study. Application SPSS19.0 software, P <0.05 for the difference was statistically significant. Results The incidence of osteoporosis in maintenance hemodialysis patients was 48%, and 25% of vitamin D deficiency was 30.4%. There was no significant difference in the prevalence of osteoporosis among different sexes. Bone mineral density in postmenopausal women was significantly lower than in non-menopausal women (P <0.001). Women 25 hydroxyvitamin D levels were significantly lower than men (P = 0.026). Bone mineral density was significantly lower in patients with tubulointerstitial disease than in those with chronic glomerulonephritis (P = 0.001). Bone mineral density was significantly lower in non-exercise group than in exercise group (P <0.001). There was a significant negative correlation between BMD and age and dialysis age (r = -0.387, P <0.001, r = -0.190 P = 0.034). Aging, menopause, light weight, non-exercise, and kidney transplantation are risk factors for osteoporosis in maintenance dialysis patients. Conclusion The incidence of osteoporosis and 25-hydroxy vitamin D deficiency in maintenance hemodialysis patients is high, but there is no correlation between them. Aging, menopause, light weight, non-exercise, application of hormones and immunosuppressive agents after renal transplantation are risk factors for osteoporosis in maintenance dialysis patients with end-stage renal disease.