Kanis J A, Earnshaw M, Henderson R G, Heynen G, Ledingham J G, Naik R B, Oliver D O, Russell R G, Smith R, Wilkinson R H, Woods C G
Clin Endocrinol (Oxf). 1977 Dec;7 Suppl:45s-50s. doi: 10.1111/j.1365-2265.1977.tb03361.x.
Thirty-five patients with bone disease and chronic renal failure (twenty-four on maintenance haemodialysis) were treated for 7--39 months with 1alpha-hydroxyvitamin D3, 2--2.5 microgram daily by mouth. Symptoms (bone pain and muscle weakness) and radiographic appearances improved and plasma alkaline phosphatase returned to normal in the majority of patients (87, 76 and 75% respectively). In contrast, histological appearances in bone improved in only 46% twenty-three patients from whom paired biopsies were available, and this change was not greatly different from that seen in a comparable group of untreated patients. Significant correlations were noted in individual patients between the changes in symptoms, X-rays, plasma alkaline phosphatase and immunoreactive parathyroid hormone and these, in turn, were related to histological changes in bone, although these latter changes were often small. It is concluded that 1alpha-hydroxyvitamin D3 is a useful new drug in the treatment of renal bone disease, but that the evaluation of the response depends critically on the method of assessment used.
35例患有骨病和慢性肾衰竭的患者（24例接受维持性血液透析）口服1α-羟维生素D3，每日2-2.5微克，治疗7-39个月。多数患者（分别为87%、76%和75%）的症状（骨痛和肌肉无力）、影像学表现有所改善，血浆碱性磷酸酶恢复正常。相比之下，在可获得配对活检的23例患者中，只有46%的患者骨组织学表现有所改善，且这种变化与未治疗的可比组患者所见变化差异不大。在个体患者中，症状、X线、血浆碱性磷酸酶和免疫反应性甲状旁腺激素的变化之间存在显著相关性，这些变化又与骨组织学变化相关，尽管后者的变化通常较小。结论是，1α-羟维生素D3是治疗肾性骨病的一种有用新药，但对反应的评估关键取决于所采用的评估方法。
