Brown D J, Dawborn J K, Thomas D P, Xipell J M
Aust N Z J Med. 1982 Jun;12(3):250-4. doi: 10.1111/j.1445-5994.1982.tb02470.x.
Nine patients with chronic renal failure were followed for more than one year by serial bone biopsies which were assessed by quantitative histological techniques. All patients had evidence of bone disease; this progressed during the interbiopsy period in eight. Patients who had the most advanced histologic disease at initial biopsy showed the most progression in resorption and demineralization, but with greater progression of hyperparathyroid bone disease than osteomalacia. The type of bone disease and its rate of progression could only be accurately assessed histologically. No predictive parameters of early bone disease were found from clinical history, biochemistry or radiology. Raised serum alkaline phosphatase occurred only in advanced hyperparathyroid bone disease. Minor radiological abnormalities in magnified views of the hands were indicative of histologically advanced asymptomatic hyperparathyroidism.
对9例慢性肾衰竭患者进行了为期一年多的随访，通过定量组织学技术对连续的骨活检样本进行评估。所有患者均有骨病证据；其中8例在两次活检期间骨病有所进展。初始活检时组织学病变最严重的患者，其吸收和脱矿进展最大，但甲状旁腺功能亢进性骨病的进展比骨软化症更大。骨病的类型及其进展速度只能通过组织学准确评估。从临床病史、生化检查或放射学检查中未发现早期骨病的预测参数。血清碱性磷酸酶升高仅出现在晚期甲状旁腺功能亢进性骨病中。手部放大视图中的轻微放射学异常提示组织学上进展的无症状甲状旁腺功能亢进。
