目的 探讨肾移植术后患者与正常体检人群骨密度(bone mineral density, BMD)水平,以及骨量丢失(骨量减少和骨质疏松)发病率的差异。方法 选择在武警总医院随访的肾移植患者177例(男104例,女73例),根据女性是否绝经和男性年龄将入选者分为＜50岁男性、≥50岁男性、绝经前女性和绝经后女性移植组。选择同期在我院体检的正常人群250例(男131例、女119例)作为对照组。采用双能X线骨密度仪测定所有人的腰椎、右股骨颈和右全髋BMD,比较各移植组与对照组BMD以及骨量丢失发病率的差异。结果 各肾移植组患者股骨颈和全髋骨密度均低于对照组(P<0.01);＜50岁男性肾移植患者腰椎骨密度低于对照组(P<0.01)。男性和绝经后女性移植患者骨量丢失(包括骨量减少和骨质疏松)发病率显著高于对照组(P<0.01)。结论 肾移植患者骨密度水平明显低于正常体检人群,且骨量丢失的发病率高于正常人群。建议肾移植患者术后在维生素D和钙剂的基础上,选用双膦酸盐防治骨质疏松和骨折。
Abstract
Objective To study the differences in bone mineral density (BMD) and incidence of bone loss (osteopenia and osteoporosis). Methods Todally 177 renal transplantation recipients (104 males, 73 females) were divided into postmenopausal women, premenopausal women and ＜50-year-old males and ≥50-year-old males. And 250 people with normal physical examination (131 males, 119 females) were included in control group. Bone mineral densities of the lumbar spine, right femoral neck and right hip were assessed by dual X-ray absorptiometry. The transplantation group and the control group were compared in the BMD and incidence of bone loss. Results BMDs of right femoral neck and right hip in all transplantation group were significantly lower than those in the control group (P<0.01).BMD of the lumbar spine in transplantation group of ＜50-year-old males was significantly lower than that in the control group(P<0.01).The incidences of bone loss in males and postmenopausal women were significantly higher than those in the control group(P<0.01). Conclusions BMD in renal transplantation recipients is lower than in normal physical examination. The prevalence of bone loss in renal transplantation recipients is significantly higher than that in normal people. It is suggested that we should on the basis of vitamin and calcium ,select diphosphonate to prevent and treat osteoporosis and bone fracture after renal transplantation.
关键词
肾移植 /
骨密度 /
骨质疏松 /
骨量减少
Key words
renal transplantation /
bone mineral density /
osteoporosis /
osteopenia /
bone loss
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参考文献
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基金
肾移植后骨质疏松预防和治疗的前瞻随机对照研究(项目编号WZ2011009)
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