骨密度测定在继发性甲状旁腺素机能亢进症骨病中的应用.pdfVIP

2000, 25( 1) BULL HUNAN MED UNIV 77 宁建平, 孙 明 湖南医科大学附属湘雅医院肾内科( 长沙 410008) 池田, 吉留悦男 日本国鹿儿岛鹿屋市池田病院 [ ] 采用双能X 线骨密度测定法检测185 例慢性肾衰血透患 的桡骨骨密度( BMD) , 计算其Z 值, 同时检测 其血清甲状旁腺素(PTH) , 碱性磷酸酶(ALP) 和指骨X 照片结果显示: 血透患 骨密度低于正常对照组( P 0.05) , 并随透析时间延长进一步减低; 骨密度与其PTH, ALP 和指骨骨膜下吸收呈负相关; 用Z 值对继发性甲状旁腺机能亢 进症骨病( 甲旁亢骨病) 作诊断试验, 受试 运筹特性曲线显示, 当Z - 2. 2 时, 灵敏度为794 1% ,特异度为 7815% 骨密度测定对甲旁亢骨病诊断具有临床应用价值 [ ] 血液透析; 骨密度; 甲状旁腺机能亢进症, 骨病, 继发性* + [ ] R582 1 [ ] A [ ] 10005 25(2000) The relationship between bone mineral density and secondany hyperparathyroidism bone disease NING Jianping, SUN Ming Department of Nephrology , XianyaH osp ital , Hunan Medi al University ( Changsha 410008) TORU Ikeda, ETSUO Yoshidome IkedaH osp ital , Kanoya, Kagashima, Jap an [ Abstract] The bone mineral density( BMD) and Z score in distal 1/ 3 radius were measured with dual energy Xray absorptiometry( DEXA) in 185 hemodialysis( HD) patients, meanwhile serum parathyroid hormone (PTH) , alkaline phosphatase(ALP) and hand Xrays were detected. Results showed that BMD in HD patients was significantly lower than that in control group( P 0. 05) , and decreased with dialysis duration increasing. BMD in HD patients was negatively relatedwith PTH, ALP and rate of subperiosteal erosions. By using Z score to diagnose hyperparathyroidism bone disease, receiver operating characteristic( ROC) curve wasworked out. If Z score - 2. 2, the sensitivity was 79. 41% and specificity was 7