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目的:探讨老年维持性血液透析患者骨密度变化特点。方法:维持性血液透析老年患者40例为透析组,同期老年健康体检者40例为对照组。采用双能X线骨密度仪测量2组腰椎(L1-4)及左侧股骨骨密度,同时检测2组血钙、血磷及透析组甲状旁腺素等指标。结果:血液透析患者股骨颈骨密度及股骨大转子密度均低于对照组(P<0.05),而腰椎骨密度比较差异无统计学意义(P>0.05);透析组血钙及血磷浓度以及及骨折发生率均高于对照组(P<0.05);透析组中骨质疏松患者透析时间较非骨质疏松患者长(P<0.05),血钙、血磷高于非骨质疏松者(P<0.05),甲状旁腺素水平较非骨质疏松者低(P<0.05)。结论:老年维持性血液透析患者骨密度下降以皮质骨明显,多不伴有低钙血症但甲状旁腺素水平偏低。
Objective: To investigate the changes of bone mineral density in elderly patients with hemodialysis. Methods: 40 cases of hemodialysis elderly patients were dialysis group, 40 cases of elderly health examination over the same period as the control group. The bone mineral density (BMD) of lumbar vertebrae (L1-4) and left femur were measured by dual energy X-ray absorptiometry. The levels of serum calcium, serum phosphorus and parathyroid hormone in dialysis group were also measured. Results: BMD and femoral greater trochanter density in hemodialysis patients were lower than those in control group (P <0.05), while there was no significant difference in lumbar BMD (P> 0.05) (P <0.05). The duration of dialysis in osteoporosis patients in dialysis group was longer than that in non-osteoporosis patients (P <0.05), and the levels of serum calcium and phosphorus were higher than those in non-osteoporosis patients P <0.05), parathyroid hormone levels were lower than non-osteoporosis (P <0.05). CONCLUSIONS: Bone densities in elderly patients with maintenance hemodialysis were significantly lower in cortical bone, less in hypocalcemia and lower in parathyroid hormone.