老年肾小管功能与骨质疏松关系的临床研究

Clinical Research on Relationship between Renal Tubule Function and Osteoporosis in Old Men

目的:随着人体衰老及各种代谢紊乱,肾组织结构及功能亦发生明显的减退。肾小管功能对骨代谢有重要影响。本研究通过对骨质疏松病人肾小管功能的观察,分析骨质疏松与肾小管功能的关系。方法:对15例骨质疏松的住院病人进行骨密度(BMD)、血钙、尿钙、骨钙紊(BGP)及同位素肾小管功能检测。结果:BMD与BGP、血钙无明显相关,与尿钙、同位素肾小管功能呈明显相关关系,r分别为-0.6778,0.5333,均P小于0.05。BGP与同位素肾小管功能亦密切相关,r=0.5281,P<0.05。结论:提示肾小管功能减退是引起骨质疏松的因素之一。因此对老年人不仅要注意补充钙和维生素D,还应高度重视对肾小球及肾小管功能的保护,避免应用肾毒药物,延缓肾脏退变,从而预防骨质疏松的发生。

Objective: With the physiological aging of human body and diversified metabolic disorders, the tissue structure and function of the kidney deteriorate obviously. The function of renal tubule has important influence on bone metabolism. By observing renal tubule function in osteoporotic patients, the relationship between renal tubule function and osteoporosis was investigated. Methods: Bone mineral density (BMD),serum calcium,urinary calcium,bone gla proteins (BGP),and isotopic renal tubule function in 15 osteoporotic patients were determined. Results: It turned out that BMD had no relationship with serum calcium but had strong relationship with urinary calcium and isotopic renal tubule function. The BGP had intensive relationship with isotopic renal tubule function (r = 0.528 1, P< 0.05 ).Conclusion:The research implied that the functional deterioration of renal tubule was one of the factors that caused osteoporosis. So it is important not only to pay attention to the supplementation of calcium and Vitamin D,but also to protect renal glomeruli and renal tubule, to avoid administering kid-neypoisoning drugs and to defer the decay of the kidney on aged people so as to prevent the occurrence of osteoporosis.