Ott S M, Maloney N A, Coburn J W, Alfrey A C, Sherrard D J
N Engl J Med. 1982 Sep 16;307(12):709-13. doi: 10.1056/NEJM198209163071202.
A histochemical stain for bone aluminum allowed us to determine the prevalence and staining characteristics of aluminum in renal osteodystrophy. The staining method correlated well with the results of atomic-absorption studies in 96 samples (r = 0.81; P less than 0.001). We examined 315 bone-biopsy samples. No aluminum was seen in controls or patients with nonrenal bone disease. In renal osteodystrophy, the mean level of stainable aluminum was significantly higher in osteomalacic lesions (1.12 +/- 0.09 mm per square millimeter of tissue area) than in mild, mixed, of fibrotic lesions (0.43 +/- 0.06, 0.34 +/- 0.11, and 0.10 +/- 0.03 mm per square millimeter, respectively; P less than 0.001). Seventy per cent of osteomalacic samples had heavy aluminum staining. The bone-apposition rate, measured by double tetracycline labels, was low in 89 per cent of the samples with high levels of aluminum. The mean level of stainable bone aluminum in patients who had a clinical response to calcitriol was significantly lower than in those who did not respond (0.13 +/- 0.4 vs. 1.06 +/- 0.9 mm per square millimeter; P less than 0.01). We conclude that aluminum deposition is associated with impaired bone formation or mineralization and with a poor response to calcitriol therapy.
一种用于检测骨铝的组织化学染色方法，使我们能够确定肾性骨营养不良中铝的患病率及染色特征。该染色方法与96份样本的原子吸收研究结果具有良好的相关性（r = 0.81；P < 0.001）。我们检查了315份骨活检样本。在对照组或非肾性骨病患者中未发现铝。在肾性骨营养不良中，骨软化性病变中可染色铝的平均水平（每平方毫米组织面积1.12±0.09毫米）显著高于轻度、混合型或纤维化病变（分别为每平方毫米0.43±0.06、0.34±0.11和0.10±0.03毫米；P < 0.001）。70%的骨软化样本有重度铝染色。通过双四环素标记测量的骨沉积率，在89%铝含量高的样本中较低。对骨化三醇有临床反应的患者中可染色骨铝的平均水平显著低于无反应者（每平方毫米0.13±0.4对1.06±0.9毫米；P < 0.01）。我们得出结论，铝沉积与骨形成或矿化受损以及对骨化三醇治疗反应不佳有关。
