老年维持性血液透析患者骨密度的测定结果与分析

The analysis about the results of bone density in elderly patients on maintenance hemodialysis

目的对老年维持性血液透析(maintenance hemodialysis,MHD)患者骨密度情况进行测定研究,了解骨质疏松患病情况。方法选择首都医科大学宣武医院肾内科血液净化中心56例老年MHD患者作为试验组,52例中青年MHD患者及43例老年终末期尿毒症非透析患者分别作为对照组。记录患者的年龄、性别、身高、体质量、骨折等资料。采用双能X线骨密度仪测量所有样本的第1～4腰椎及股骨骨密度等指标。用SPSS软件进行统计学分析。结果老年透析组骨质疏松总患病率、股骨骨质疏松患病率分别高于老年非透析组和中青年透析组(P<0.05);腰椎骨质疏松患病率相比差异无统计学意义(P>0.05),而老年透析组女性腰椎骨质疏松患病率高于老年男性,差异有统计学意义(P<0.05)。结论老年MHD患者与其他人群相比骨密度下降以皮质骨为明显,骨质疏松患病率高,患病情况更严重且更易发生骨折,应给予针对性治疗。

Objective To explored bone mineral loss and osteoporosis in elderly patients on maintenance hemodialysis （MHD）. Methods We recruited 56 aged patients on MHD treated in the Blood Purification Center of Nephrology Department,Beijing Xuanwu Hospital,Capital Medical University,as the test group. We also recruited 52 young patients on MHD and 43 elderly patients with end stage renal disease （ESRD） but without dialysis as the control groups. Their age,sex,height,body weight and bone fracture events were recorded. Mineral density of spinal bones （L1～L4） and femoral bones were measured by dual energy X ray absorptiometry. SPSS software was used for statistical analysis. Results The frequency of femoral osteoporosis was higher in test group than in the elderly ESRD patients without dialysis group and the young patients on dialysis group （P〈0.05）. The frequency of lumbar osteoporosis showed no difference among the 3 groups （P〉0.05）,but was higher in females than in males in test group （P〈0.05）. Conclusion Elderly patients on MHD are more likely to have femoral osteoporosis.