Scheutzel P
Zentrum für Zahn-, Mund- und Kieferkrankheiten der Westfalischen Wilhelms-Universität Münster.
Dtsch Zahnarztl Z. 1991 Nov;46(11):737-40.
Thirty-four children with chronic renal failure were examined to evaluate the character and frequency of radiographic changes in the jawbones as related to radiographic abnormalities in other skeletal regions and laboratory data. Twenty-seven children showed signs of renal osteodystrophy on the roentgenograms. Radiographic changes in the jawbones including alterations of the laminae durae were observed in twenty-three children. Total loss of laminae durae was only seen in connection with other skeletal signs of renal osteodystrophy. In all these cases the serum parathyroid hormone (iPTH-C) and alkaline phosphatase levels were remarkably increased so that even in the uremic child total absence of laminae durae cannot be considered a first symptom of renal osteodystrophy. However, radiographic changes in the jawbones are important signs for early detection of renal insufficiency in childhood, as these symptomes appeared with similar frequency as pathologic changes in other skeletal regions and were already present in stage of preterminal renal insufficiency.
对34名慢性肾衰竭儿童进行了检查,以评估颌骨放射学改变的特征和频率,及其与其他骨骼区域放射学异常和实验室数据的关系。27名儿童的X线片显示有肾性骨营养不良的迹象。23名儿童观察到颌骨的放射学改变,包括硬骨板改变。硬骨板完全消失仅见于伴有肾性骨营养不良其他骨骼体征的情况。在所有这些病例中,血清甲状旁腺激素(iPTH-C)和碱性磷酸酶水平显著升高,因此即使在尿毒症患儿中,硬骨板完全缺失也不能被视为肾性骨营养不良的首发症状。然而,颌骨的放射学改变是儿童期早期发现肾功能不全的重要体征,因为这些症状出现的频率与其他骨骼区域的病理改变相似,且在终末期前肾功能不全阶段就已出现。