Diagnosis and Stomatology Department, Universidade Federal de Uberlândia, Avenida Pará, 1720. Bloco 2G, Sala 08. Bairro Umuarama, Uberlândia, Minas Gerais, 38405-320, Brazil.
Oral Imaging Center, Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000, Louvain, Belgium.
Oral Radiol. 2018 May;34(2):172-178. doi: 10.1007/s11282-017-0302-z. Epub 2017 Sep 4.
Secondary hyperparathyroidism (SHPT) is a disease that affects patients with chronic kidney disease, and is characterized by mineral disturbance and bone loss, known as renal osteodystrophy. The aim of this study was to assess the validity of using intraoral phosphor storage plates to take radiographs of the middle phalanges to evaluate bone loss resulting from SHPT during follow-up of these patients.
The sample consisted of 24 patients with chronic kidney disease, 12 with parathyroid hormone (PTH) levels ≥500 pg/ml, and 12 with PTH levels <500 pg/ml, who underwent hemodialysis weekly. For each patient, a panoramic radiograph and digital radiographs of the ring, index, and middle fingers of both hands were taken. The Mandibular Cortical Index (MCI) and the Trabecular Bone Pattern Index (TBP) were applied to the panoramic radiographs, while the Phalangeal Cortical Index (PCI) was applied to the digital radiographs of the phalanges. Three evaluators performed all analyses.
Significant correlations were found between the PTH levels and the MCI (p = 0.023), the PCI (p = 0.039) and the TBP index (p = 0.032). These parameters were also significantly interrelated (MCI × PCI = 0.001; MCI × TBP = 0.004 and PCI × TBP = 0.009). The PCI was shown to have the highest correlation with PTH levels.
In patients with chronic renal disease, it is clinically relevant to use panoramic and digital radiographs using intraoral storage plates to assess a number of quantitative parameters that can be linked to PTH levels.
继发性甲状旁腺功能亢进症（SHPT）是一种影响慢性肾脏病患者的疾病，其特征是矿物质紊乱和骨丢失，即肾性骨营养不良。本研究旨在评估使用口腔内磷储存板拍摄中节指骨 X 光片来评估这些患者随访期间因 SHPT 导致的骨丢失的有效性。
该样本包括 24 名慢性肾脏病患者，12 名甲状旁腺激素（PTH）水平≥500 pg/ml，12 名 PTH 水平<500 pg/ml，每周进行一次血液透析。为每位患者拍摄全景 X 光片和双手环指、食指的数字 X 光片。应用下颌皮质指数（MCI）和小梁骨形态指数（TBP）于全景 X 光片，而应用指骨皮质指数（PCI）于指骨数字 X 光片。三名评估者对所有分析进行了操作。
发现 PTH 水平与 MCI（p=0.023）、PCI（p=0.039）和 TBP 指数（p=0.032）之间存在显著相关性。这些参数之间也存在显著的相互关系（MCI×PCI=0.001；MCI×TBP=0.004 和 PCI×TBP=0.009）。PCI 与 PTH 水平的相关性最高。
在慢性肾病患者中，使用口腔内储存板拍摄全景和数字 X 光片来评估与 PTH 水平相关的多个定量参数具有临床意义。
