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(TPⅠNP)、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TPⅠNP、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,TPⅠNP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、TPΙNP、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TPⅠNP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。
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（TPⅠNP）,β-isomerized carboxyterminal propeptide（β-CTx）,intact parathyroid hormone（iPTH）,serum calcium（Ca2＋）,serum phosphorus（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 TPⅠNP,β-CTx,iPTH,P,ALP,Cr,Bun and β2-MG,in the CKD group which were significantly different according to Mann-Whitney U test（P0.05 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（P0.05）.Correlation analysis showed TPⅠNP was positively correlated with β-CTx,iPTH,P,CaxP,ALP,Cr,Bun,β2-MG（r was 0.790,0.681,0.573,0.541,0.550,0.705,0.598,0.793 respectively,P0.01）,Correlation analysis showed β-CTx was positively corelated with iPTH,P,CaxP,ALP,Cr,Bun,β2-MG（r was 0.803,0.527,0.449,0.659,0.672,0.565,0.624 respectively,P0.01）.TPⅠNP was negatively correlated with Ca2＋ and 1,25（OH）2D3（r was-0.302,-0.582 respectively,P0.01）.β-CTx was negatively correlated with Ca2＋ and 1,25（OH）2D3（r was-0.265,-0.595 respectively,P0.01）.The iPTH was positively correlated with age,TPΙNP,β-CTx,P,CaxP,ALP,Cr,Bun and β2-MG（r was 0.485,0.681,0.803,0.630,0.541,0.486,0.690,0.648,0.531 respectively,P0.05或0.01）,but was negatively correlated with Ca2＋ and 1,25（OH）2D3（r was-0.318,-0.621 respectively,P0.05）.Conclusion The application of total procollagen typeⅠamino-terminal propeptide（TPΙNP）,β-isomerized carboxyterminal propeptide（β-CTx） is helpful for the early diagnosis of renal osteodystrophy in patients with chronic kidney disease.
出处
《苏州大学学报（医学版）》
CAS
2012年第1期112-115,共4页
Suzhou University Journal of Medical Science
关键词
骨转换标志物
肾性骨营养不良
慢性肾脏病
bone turnover marker
renal osteodystrophy
chronic kidney diseases
