Faugere M C, Malluche H H
Kidney Int. 1986 Nov;30(5):717-22. doi: 10.1038/ki.1986.246.
Quantitative evaluation of stainable bone aluminum and measurement of bone aluminum content were done in 55 patients on chronic maintenance dialysis. All patients underwent bone biopsies. Histomorphometry of static and dynamic parameters of bone structure, bone formation and resorption, and quantitation of stainable bone aluminum at the osteoid-bone interface were performed. In addition, bone aluminum content was measured by atomic absorption spectrophotometry. Bone aluminum content was elevated in all patients (81 +/- 9.6 vs. 18 +/- 6 micrograms/g dry wt) and stainable aluminum was found in 47% of them. All patients with predominant low-turnover osteomalacia or adynamic bone disease displayed stainable bone aluminum. In contrast, stainable bone aluminum was not present in individuals with predominant-hyperparathyroid bone disease. Patients with stainable aluminum had lower bone mass (P less than 0.05), higher volume and surface of lamellar osteoid (P less than 0.01), less volume and surface of woven osteoid (P less than 0.05 and P less than 0.01), lower osteoblastic and osteoclastic indices (P less than 0.01), less doubly labelled osteoid seams, lower mineral apposition rate and lower bone formation rates (P less than 0.05 to P less than 0.01). Stainable aluminum correlated with volume of lamellar osteoid and cellular parameters of bone formation and resorption, mineral apposition rate, and bone formation rates (P less than 0.05 to P less than 0.001). In contrast, bone aluminum content correlated with volume of lamellar osteoid only (P less than 0.001). These findings indicate that stainable aluminum at the mineralization front and not aluminum content of bone reflects the histopathologic changes found in bone of dialyzed patients.
对55例慢性维持性透析患者进行了可染色骨铝的定量评估及骨铝含量测定。所有患者均接受了骨活检。对骨结构、骨形成和吸收的静态及动态参数进行了组织形态计量学分析，并对类骨质-骨界面处的可染色骨铝进行了定量分析。此外，采用原子吸收分光光度法测定骨铝含量。所有患者的骨铝含量均升高（81±9.6 vs. 18±6微克/克干重），其中47%发现有可染色铝。所有以低转换型骨软化症或骨动力不足为主的患者均显示有可染色骨铝。相比之下，以甲状旁腺功能亢进性骨病为主的患者未发现有可染色骨铝。有可染色铝的患者骨量较低（P<0.05），板层类骨质的体积和表面积较高（P<0.01），编织类骨质的体积和表面积较小（P<0.05和P<0.01），成骨细胞和破骨细胞指数较低（P<0.01），双标记类骨质缝较少，矿物质沉积率和骨形成率较低（P<0.05至P<0.01）。可染色铝与板层类骨质体积以及骨形成和吸收的细胞参数、矿物质沉积率和骨形成率相关（P<0.05至P<0.001）。相比之下，骨铝含量仅与板层类骨质体积相关（P<0.001）。这些发现表明，矿化前沿的可染色铝而非骨铝含量反映了透析患者骨组织病理学变化。
