摘要
目的 研究肾移植患者术后的骨质疏松症发生情况 ,探讨有效的防治手段。方法 测定一组肾移植患者手术前后及采用α -D3 和降钙素等治疗后的骨密度 (BMD)改变和生化指标的变化。结果 ①肾移植患者术后 6～ 12月BMD较移植前明显下降 ,其腰椎骨密度Z值平均值低于 - 2 ;②采用α -D3 、降钙素及钙剂联合治疗后 ,其效果明显优于仅用α -D3 及钙剂治疗者。结论 ①肾移植后出现的骨质疏松症与术后应用皮质激素及环胞素A(CsA)有关 ,术前可能存在的继发性甲状旁腺功能亢进和肾性骨病加重了患者BMD的下降 ;②联合应用α -D3 、降钙素及钙剂治疗肾移植后骨质疏松症是安全有效的。
Objective To study the incidence of osteoporosis in patients undergoing kidney transplantation, and explore the curative effect and safty of osteoporosis. Methods After renal transplantation 6-12 months, 60 patients were randomly divided into two group. Group 1 was treated with α-D 3 ,calcitonin combinated calcium salts, group 2 was treated with α-D 3 and calcium salts only. Bone mineral density (BMD) and metabolic parameters were measured in patients before and 12 months after transplantation. Results 1.The mean BMD of the abdominal vertebrae, femora and neck were decreased after transplantation in all patients, the mean L-Z score was less than -2. 2. BMD of group 1 was higher than group 2. Conclusion 1.Osteoporosis after kidney transplantation may be related to the immunosuppressive, glucocorticoid and cyclosporine A therapy. Other factors such as secondary hyperparathyroidism before transplantation and renal osteodystrophy may also exacerbate BMD reducing in recipients. 2. α-D 3, calcitionin combinated calcium salts was effective and safe for osteoporosis after kideny transplantaion.
