摘要
目的：探讨不同亚型的特发性高尿钙症（IH）对患者骨代谢的影响。方法：采用双能X线骨密度仪，测定72例IH患者和72例年龄、性别、体重指数与之相匹配的健康体检者的腰椎及左髋部骨密度（BMD）值，并行骨代谢生化指标的检测。结果：IH患者的尿Ca/Cr、尿DPD/Cr水平明显高于对照组，具有极显著性差异（P<0.01）；肠吸收型组的血清BALP、PTH和BGP水平与对照组比较无显著差异，而肾脏漏出型组的BALP、PTH与BGP水平高于正常对照组，差异有统计学意义（P<0.05）。肾脏漏出型组患者的股骨颈BMD和腰椎BMD值均较肠吸收型组及对照组低；指标BGP、BALP及DPD与各部位BMD之间均呈负相关关系。结论：对于泌尿系结石患者，应注意IH的可能。IH患者常存在骨量减少和骨代谢紊乱，合理检测骨密度和骨代谢生化指标，有助于IH患者骨代谢紊乱的早期诊断和监测。
Abstract
Objective: To evaluate the effects of different subtypes of idiopathic hypercalciuria(IH) on bone metabolism. Methods: Using dual-energy X-ray absorptiometry, bone mineral density(BMD) in lumbar spine and left femur were measured in 72 patients with IH and 72 age, sex and body weight index matched healthy persons. Biochemical markers of bone metabolism were also measured in all subjects. Results: In comparison to the control group, the patients with IH had significantly higher urinary Ca/Cr and DPD/Cr levels(P<0.01), and serum BALP, PTH and BGP levels were significantly higher in renal IH patients(P<0.05), whereas there was no significant difference between absorptive IH group and control group in serum BALP, PTH and BGP levels. Renal IH patients had significantly lower femoral neck BMD and lumbar spine BMD values when compared with control subjects. There was a significant negative correlation between BMD in different sites and the serum BALP, BGP and urinary DPD levels. Conclusion: Patients with renal lithiasis should be evaluated for IH. Osteopenia and disorder of bone metabolism are common in patients with IH, and monitoring the BMD and biochemical markers of bone is beneficial to early detection of such abnormalities for those patients.
关键词
钙代谢障碍 /
骨密度
Key words
Calcium metabolism disorders /
Bone density
张思伟;王毅明;游玉梅.
特发性高尿钙症对病人骨密度及骨代谢指标的影响[J]. 中国临床医学影像杂志. 2009, 20(8): 607-610
ZHANG Si-wei;WANG Yi-ming;YOU Yu-mei.
Influences on bone mineral density and biochemical markers in patients with idiopathic hypercalciuria[J]. Journal of China Clinic Medical Imaging. 2009, 20(8): 607-610
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