摘要
目的 探讨慢性肾脏病患者肾性骨营养不良与骨转换生化标志物的相关关系.方法 分别检测102例慢性肾脏病(CKD)患者和52例健康成年人血清中骨转换生化标志物总Ⅰ型前胶原氨基端延长肽(TP Ⅰ NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、完整甲状旁腺素(iPTH)及血清钙(Ca2+)、血清磷(P)、碱性磷酸酶(ALP)等相关生化指标,分析引起肾性骨营养不良的相关危险因素.结果 CKD患者TP I NP、β-CTx、iPTH、P、ALP、Cr、Bun、血 清β2微球蛋白(β2-MG)均高于正常对照组(P＜0.05或＜0.01),血清Ca2+、1,25羟维生素[1,25(OH)2D3]明显低于正常对照组(均P＜0.05).相关性分析显示,TP Ⅰ NP和β-CTx、iPTH、P、CaxP、ALP、Cr、Bun、β2-MG呈正相关(r 分别为0.790、0.681、0.573、0.541、0.550、0.705、0.598、0.793,均P＜0.01),和Ca2+、1,25 (OH) 2D3呈负相关(r分别为-0.302、-0.582,均P＜0.01)；β-CTX与iPTH、P、CaxP、ALP、Cr、Bun、β2-MG呈正相关(r分别为0.803、0.527、0.449、0.659、0.672、0.565、0.624,均P＜0.01),与Ca2+、1,25(OH)2D3呈负相关(r分别为-0.265、-0.595,均P＜0.01).年龄、TPINP、β-CTx、P、CaxP、ALP、Cr、Bun、β2-MG与血清iPTH值呈正相关(r分别为0.485、0.681、0.803、0.630、0.541、0.486、0.690、0.648、0.531,P＜0.05或P＜0.01),Ca2+、(1,25( OH)2) D3与血清iPTH值呈负相关(r分别为-0.318、-0.621,均P＜0.05).结论 联合检测骨转换生化指标TP Ⅰ NP和β-CTx可有助于对CKD患者并发肾性骨营养不良的早期诊断.
Abstract
Objective To investigate the relationship between renal osteodystrophy and the biochemical marker of bone turnover in patients with chronic kidney diseases. Methods A total of 102 patients with chronic kidney diseases (CKD)and 52 healthy subjects (normal control) were included in this study. The level of total procollagen type I amino-terminal propeptide of (TP I NP) , p-isomerized carboxyter-minal propeptide (p-CTx), intact parathyroid hormone (iPTH), serum calcium ( Ca2+ ), serum phos-phorus(P), alkaline phosphatase( ALP) were detected. The correlations between renal osteodystrophy in the patients with chronic kidney diseases and other related factors were analyzed. Results Compared with the normal control group, there were higher TP I NP,p-CTx,iPTH,P,ALP,Cr,Bun and (3 2-MG, in the CKD group which were significantly different according to Mann-Whitney U test (P < 0. 05 or <0.01). The Ca2 + and 1, 25-OH Vitamin D3 [ 1,25(OH)2D3 ] in the CKD group were significantly decreased compared with the normal control group (P <0. 05). Correlation analysis showed TP I NP was positively correlated with |3-CTx, iPTH, P, CaxP, ALP, Cr, Bun, p2-MG ( r was 0. 790,0. 681,0. 573, 0.541,0.550,0.705,0.598,0.793 respectively ,P <0.01) , Correlation analysis showed 0-CTx was positively corelated with iPTH, P, CaxP, ALP, Cr, Bun, p2-MG ( r was 0. 803,0. 527,0.449,0. 659,0. 672, 0.565,0.624 respectively,P<0.01). TP I NP was negatively correlated with Ca2+ and 1,25(OH)2D3 (r was -0.302, -0.582 respectively,P<0.01). P-CTx was negatively correlated with Ca2+ and 1,25 ( OH) 2D3 (r was - 0. 265, - 0. 595 respectively, P < 0. 01). The iPTH was positively correlated with age,TPINP,p-CTx,P, CaxP, ALP, Cr, Bun and |32-MG(r was 0.485,0.681,0.803,0.630,0.541, 0.486,0.690,0.648,0.531 respectively,P<0. 05或 <0.01) , but was negatively correlated with Ca2+ and 1,25 (OH)2D3 ( r was - 0. 318, - 0. 621 respectively,P < 0. 05 ). Conclusion The application of total procollagen type I ammo-terminal propeptide(TPINP) , p-isomerized carboxyterminal propeptide (β-CTx) is helpful for the early diagnosis of renal osteodystrophy in patients with chronic kidney disease.
NETL
NSTL
维普
万方数据