Kokot F, Kuska J, Sledziński Z, Białas B, Luciak M
Z Gesamte Inn Med. 1979 Nov 15;34(22):665-70.
In 18 patients with chronic renal failure the parathormone (PTH), calcitonin (CT) and 25-OH-D blood levels were estimated before and after an intravenous calcium load. In ten patients the above mentioned biochemical parametres were confronted with histological findings obtained in bone biopsy material. Significantly elevated levels of PTH and CT were found while those of 25-OH-D were normal. Serum PTH decreased after a calcium load. In contrast to healthy persons no increase of serum CT was stated. Significant positive correlations were found between PTH and CT levels in blood serum as well as between the mineralized bone volume and 25-OH-D levels in serum. In addition a significant negative correlation was stated between the osteoid volume and 25-OH-D levels in blood serum. From the results obtained it is concluded, that from estimations of PTH, CT and 25-OH-D in blood serum histological alterations in bone biopsy material from chronic uremic patients can not be predicted. Beside secondary hyperparathyreoidism, relative deficiency of CT and active vitamin D metabolites other factors are also involved in the pathogenesis of renal osteodystrophy.
对18例慢性肾衰竭患者,在静脉注射钙负荷前后分别测定了甲状旁腺激素(PTH)、降钙素(CT)和25-羟基维生素D(25-OH-D)的血药浓度。对其中10例患者,将上述生化参数与骨活检材料的组织学检查结果进行了对比。结果发现PTH和CT水平显著升高,而25-OH-D水平正常。钙负荷后血清PTH降低。与健康人不同,未观察到血清CT升高。血清中PTH与CT水平之间、矿化骨体积与血清25-OH-D水平之间存在显著正相关。此外,类骨质体积与血清25-OH-D水平之间存在显著负相关。根据所得结果得出结论,通过测定血清中的PTH、CT和25-OH-D,无法预测慢性尿毒症患者骨活检材料中的组织学改变。除继发性甲状旁腺功能亢进、CT相对缺乏和活性维生素D代谢产物外,其他因素也参与了肾性骨营养不良的发病机制。