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目的通过对维持性血液透析患者血清中巨噬细胞集落刺激因子(macrophage colonystimulating factor,M-CSF)水平及骨密度(bone mineral density,BMD)的检测,探讨血清M CSF水平与维持性血液透析患者BMD的关系,以及影响BMD的相关因素。方法选择华中科技大学同济医学院附属同济医院血液透析中心维持性血液透析患者50例为观察组,另选择健康体检者8例为健康对照组。收集入选者的临床资料包括性别、年龄、血红蛋白、血钾、血磷、血钙、甲状旁腺素、尿素氮、尿酸和血肌酐的情况。用ELISA法检测2组患者透析前血清M-CSF浓度。用骨密度仪检测所有患者BMD,结果以T-Score表示。Spearman分析BMD、M-CSF与各临床指标的相关性。血液透析患者分别按照BMD值分为骨质疏松组、骨量减少组和骨密度正常组,分析不同组别中BMD值与M-CSF的相关性。结果①观察组患者M-CSF水平与健康对照组比较明显升高(P<0.0001);Spearman相关性分析发现BMD与年龄呈负相关(r=-0.2756,P=0.0264),与性别(r=0.3701,P=0.0041)呈正相关,女性患者骨质疏松的发生率更高。②观察组M-CSF与BMD进行spearman相关性分析,发现按照T-Score分组后,骨质疏松组M-CSF与BMD呈负相关(r=-0.3842,P=0.0522);骨密度正常组(r=-0.1324,P=0.3490)和骨量减少组(r=-0.029 99,P=0.4501)M-CSF与BMD无明显相关。结论 M-CSF与BMD呈负相关,随着血清M-CSF水平的升高,骨密度逐渐下降,骨质疏松发生率增加。维持性血液透析患者血清M-CSF水平升高与患者骨质疏松的发生及进展有关。
Objective To investigate the relationship between serum M-CSF level and maintenance hemodialysis in maintenance hemodialysis patients with serum macrophage colony stimulating factor (M-CSF) and bone mineral density (BMD) BMD, and related factors that affect BMD. Methods Fifty patients with hemodialysis in hemodialysis center of Tongji Medical College affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected as the observation group and 8 healthy controls were selected as healthy control group. Clinical data collected for inclusion included gender, age, hemoglobin, potassium, phosphorus, calcium, parathyroid hormone, urea nitrogen, uric acid, and serum creatinine. The concentrations of M-CSF in serum before dialysis in the two groups were detected by ELISA. All patients were tested for BMD using a bone densitometer and the results were expressed as T-scores. Spearman analysis of BMD, M-CSF and the clinical relevance of the index. The hemodialysis patients were divided into osteoporosis group, osteopenia group and normal BMD group according to BMD value respectively. The correlation between BMD value and M-CSF in different groups was analyzed. Results ① The M-CSF level in observation group was significantly higher than that in healthy control group (P <0.0001). Spearman correlation analysis showed that BMD was negatively correlated with age (r = -0.2756, P = 0.0264) 0.3701, P = 0.0041). There was a higher incidence of osteoporosis in female patients. (2) Spearman correlation analysis between M-CSF and BMD showed that there was a negative correlation between M-CSF and BMD in osteoporosis group (r = -0.3842, P = 0.0522) There was no significant correlation between M-CSF and BMD (r = -0.1324, P = 0.3490) and osteopenia group (r = -0.029 99, P = 0.4501). Conclusions M-CSF is negatively correlated with BMD. With the increase of serum M-CSF level, BMD gradually decreases and the incidence of osteoporosis increases. Patients with maintenance hemodialysis serum M-CSF levels and osteoporosis in patients with the occurrence and progress related.