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| 慢性肾脏病伴肌少症患者骨密度改变的临床研究 |
| Clinical study of bone mineral density changes in patients with chronic kidney disease associated with sarcopenia |
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| DOI：10.3969/j.issn.1006-7108.2020.08.013 |
| 中文关键词: 骨密度 慢性肾脏病 肌少症 T值 |
| 英文关键词:bone mineral density chronic kidney disease sarcopenia T-score |
| 基金项目:吴阶平医学基金会临床科研专项资助基金（320.6750.16028）；2019年福建省财政厅课题资助基金（闽财指[2020]500号） |
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| 中文摘要: |
| 目的 探讨慢性肾脏病（chronic kidney disease，CKD）及伴肌少症患者的骨密度变化情况。方法 健康对照组57例。CKD患者123例，男性61例，女性62例，平均年龄59.8±12.6岁。以核素肾动态显像获得的肾小球滤过率，将CKD组患者分为CKD1组（CKD1~2期）和CKD2组（CKD3~5期）。将研究对象分为肌少症组和非肌少症组，检测腰椎和髋关节骨密度及体质成份，评估肌肉质量、肌肉强度。结果 ①CKD2组患者腰椎、髋部和股骨颈骨密度T值均较对照组明显减低（P＜0.05），差异有统计学意义；②CKD患者肌少症组腰椎、髋部和股骨颈骨密度均较非肌少症组骨密度T值显著减低（P＜0.05），差异有统计学意义。肌少症组和非肌少症组骨质疏松发生率分别为41.7 %、20.6 %，差异有统计学意义（χ2=6.367，P=0.012）。结论 骨密度随CKD病情进展而下降；CKD合并肌少症患者更易罹患骨质疏松。 |
| 英文摘要: |
| Objective To investigate the changes of bone mineral density (BMD) in patients with chronic kidney disease (CKD) associated with sarcopenia. Methods A total of 123 CKD patients were enrolled and grouped according to the glomerular filtration rate (GFR) obtained from dynamic radionuclide renal imaging into CKD1 (stages 1–2) and CKD2 (stages 3–5) groups. There were 61 males and 62 females with an average age of 59.8 ± 12.6 years. The control group consisted of 57 healthy volunteers. The patients were then assigned to sarcopenia and non-sarcopenia groups. Bone mineral density（BMD）of lumbar spine and hip joint were detected, as well as physical composition and additionally evaluated muscle mass and muscle strength. Results ①The CKD2 group showed significantly lower BMD T-scores at all sites compared to the control group, with significant differences in the lumbar spine, total hip and femoral neck（P＜0.05）, respectively. ②CKD patients complicated with sarcopenia showed significantly lower BMD compared to those without sarcopenia, with significantly differences in the BMD T-scores of the lumbar spine, hip and femoral neck（P＜0.05）. The incidence of osteoporosis in the sarcopenia group was 41.7%, and that in the non-sarcopenia group was 20.6%, which showed significant differences (χ2=6.367, P=0.012). Conclusion BMDs decrease as the CKD progresses. CKD patients associated with sarcopenia are more likely to develop osteoporosis. |
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