Lima Eleonora M, Goodman William G, Kuizon Beatriz D, Gales Barbara, Emerick Aletha, Goldin Jonathan, Salusky Isidro B
Division of Pediatric Nephrology, Department of Pediatrics, UCLA School of Medicine, Los Angeles, California 90095, USA.
Pediatr Nephrol. 2003 Jun;18(6):554-9. doi: 10.1007/s00467-002-1041-9. Epub 2003 Apr 24.
Peripheral quantitative computed tomography (pQCT) can selectively measure the densities of cortical and trabecular bone, but there is limited information about its use in patients with renal osteodystrophy. Thus pQCT (Norland XCT-2000, Stratec, Pforzheim, Germany) was performed at the ultradistal radius in 21 patients aged 16+/-3.6 (SD) years on continuous cycling peritoneal dialysis. Trabecular bone density (TBD) was higher in patients, 206+/-16 mg/cm(3), than in controls, 182.7+/-24.8 mg/cm(3) ( P<0.0001), whereas cortical bone density (CBD) was lower in patients, 946.5+/-147.5 mg/cm(3), than in controls, 1,153+/-25.4 mg/cm(3) ( P<0.001). TBD was inversely correlated with age ( r=-0.59, P=0.05), height ( r=-0.59, P<0.01), and weight ( r=-0.51, P<0.05). In contrast, CBD was positively correlated with age ( r=0.53, P<0.05), height ( r=0.56, P<0.05), and weight ( r=0.53, P<0.05). CBD was inversely related to serum alkaline phosphatase ( r=-0.71, P<0.001) and parathyroid hormone levels ( r=-0.50, P<0.05). In patients with adynamic bone, TBD was less, 192+/-9 mg/cm(3), than in those with high-turnover lesions, 215+/-13 mg/cm(3), P<0.001. CBD, however, was lower in patients with high-turnover lesions, 900+/-151 mg/cm(3), than in those with low turnover, 1,022+/-111 mg/cm(3), P<0.05. Compared with controls, in patients with high-turnover lesions, CBD was lower ( P<0.0001) and TBD higher ( P<0.0001). These findings suggest that pQCT may be an additional tool in the assessment of renal osteodystrophy.
外周定量计算机断层扫描（pQCT）能够选择性地测量皮质骨和小梁骨的密度，但关于其在肾性骨营养不良患者中的应用信息有限。因此，对21例年龄为16±3.6（标准差）岁、正在接受持续循环腹膜透析的患者，使用pQCT（Norland XCT - 2000，德国普福尔茨海姆的Stratec公司）在桡骨超远端进行了检测。患者的小梁骨密度（TBD）为206±16mg/cm³，高于对照组的182.7±24.8mg/cm³（P<0.0001），而患者的皮质骨密度（CBD）为946.5±147.5mg/cm³，低于对照组的1153±25.4mg/cm³（P<0.001）。TBD与年龄（r = -0.59，P = 0.05）、身高（r = -0.59，P<0.01）和体重（r = -0.51，P<0.05）呈负相关。相比之下，CBD与年龄（r = 0.53，P<0.05）、身高（r = 0.56，P<0.05）和体重（r = 0.53，P<0.05）呈正相关。CBD与血清碱性磷酸酶（r = -0.71，P<0.001）和甲状旁腺激素水平（r = -0.50，P<0.05）呈负相关。在骨动力缺乏的患者中，TBD为192±9mg/cm³，低于高转换病变患者的215±13mg/cm³，P<0.001。然而，高转换病变患者的CBD为900±151mg/cm³，低于低转换患者的1022±111mg/cm³，P<0.05。与对照组相比，高转换病变患者的CBD较低（P<0.0001），TBD较高（P<0.0001）。这些发现表明，pQCT可能是评估肾性骨营养不良的一种辅助工具。
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