Pluskiewicz Wojciech, Przedlacki Jerzy, Drozdzowska Bogna, Włodarczyk Dariusz, Matuszkiewicz-Rowińska Joanna, Adamczyk Piotr
Metabolic Bone Diseases Unit, Dept. and Clinic of Internal Diseases, Diabetology and Nephrology, Silesian School of Medicine, Katowice, Poland.
Ultrasound Med Biol. 2006 Oct;32(10):1521-7. doi: 10.1016/j.ultrasmedbio.2006.06.003.
The aim of the longitudinal study was to assess skeletal status in 29 subjects (18 males and 11 females) with end-stage renal disease (ESRD) being on regular hemodialysis. Control group consisted of 494 healthy subjects (305 males and 189 females). Skeletal status was evaluated by quantitative ultrasound measurements at the hand phalanges using DBM Sonic 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS, in m/s), performed three times: at the baseline, six and 12 months later. A precision expressed in root mean square-CV% was 0.72% in males and 0.43% in females. The values of Ad-SoS, T-score and Z-score at the baseline were significantly lower than in controls (p < 0.05). The mean values of Ad-SoS decreased over a period of observation; in the whole group from 1979 +/- 106 m/s to 1928 +/- 105 m/s, p < 0.0001, in males from 2003 +/- 93 m/s to 1949 +/- 111 m/s, p < 0.001 and in females from 1940 +/- 121 m/s to 1894 +/- 108 m/s, p < 0.05. Ad-SoS Z-scores dropped significantly over a period of the study in whole group (-1.14 +/- 1.64 to -2.08 +/- 2.26, p < 0.01), in males (-0.63 +/- 1.44 to -1.74 +/- 2.29, p < 0.0001) and in females nonsignificant decrease was observed. Using the least significant change (LSC) values for skeletal measurement, a decrease in Ad-SoS was noted in 15 subjects (52%). The values of PTH were over a normal limit. In the whole group main factors negatively influencing current Ad-SoS values were duration of dialysis, age and PTH. The skeletal status in subjects with ESRD on hemodialysis was seriously affected, and longitudinal measurements showed its aggravation over a time of the study.
这项纵向研究的目的是评估29例（18例男性和11例女性）接受定期血液透析的终末期肾病（ESRD）患者的骨骼状况。对照组由494名健康受试者（305例男性和189例女性）组成。使用DBM Sonic 1200（IGEA，卡尔皮，意大利）对手指骨进行定量超声测量来评估骨骼状况，该仪器测量与振幅相关的声速（Ad-SoS，单位为m/s），共进行三次测量：在基线时、6个月后和12个月后。男性的均方根CV%表示的精密度为0.72%，女性为0.43%。基线时Ad-SoS、T评分和Z评分的值显著低于对照组（p < 0.05）。在观察期间，Ad-SoS的平均值下降；在整个组中从1979±106 m/s降至1928±105 m/s，p < 0.0001，男性从2003±93 m/s降至1949±111 m/s，p < 0.001，女性从1940±121 m/s降至1894±108 m/s，p < 0.05。在整个研究期间，Ad-SoS Z评分在整个组中显著下降（从-1.14±1.64降至-2.08±2.26，p < 0.01），在男性中（从-0.63±1.44降至-1.74±2.29，p < 0.0001），女性中观察到非显著下降。使用骨骼测量的最小显著变化（LSC）值，15名受试者（52%）的Ad-SoS下降。甲状旁腺激素（PTH）的值超过正常范围。在整个组中，对当前Ad-SoS值产生负面影响的主要因素是透析时间、年龄和PTH。接受血液透析的ESRD患者的骨骼状况受到严重影响，纵向测量显示在研究期间其状况恶化。
