Bonucci E, Gherardi G, Faraggiana T
Virchows Arch A Pathol Anat Histol. 1976 Sep 21;371(3):183-98. doi: 10.1007/BF00433067.
Needle biopsies from the iliac crest of 40 uremic patients treated with hemodialysis have been compared by light and electron microscopy. The most obvious bone changes were represented by an increased amount of osteoid tissue (osteomalacic changes) and by enhanced bone resorption. The osteomalacic changes were chiefly characterized by the presence of thick osteoid borders whose collagen fibrils were often completely uncalcified. In a few cases, small roundish aggregates of crystals were irregularly present through the osteoid matrix; some of them were closely related to roundish, electron-dense bodies surrounded by a membrane. The increased rate of bone resorption, which was often comparable to that which occurs in the most severe cases of primary hyperparathyroidism, was due to both osteoclastic activity and osteocytic osteolysis. Electron microscopy showed that the enlargement and irregularity of the osteocytic lacunae were not always due to osteocytic osteolysis; the same effect might be due to defective calcification of the lacunar wall. The advantages of comparing the same specimens under the light and electron microscopes are discussed.
对40例接受血液透析治疗的尿毒症患者的髂嵴穿刺活检组织进行了光镜和电镜比较。最明显的骨改变表现为类骨质组织增多（骨软化改变）和骨吸收增强。骨软化改变主要表现为类骨质边界增厚，其胶原纤维常完全未钙化。少数情况下，类骨质基质中不规则地存在小圆形晶体聚集体；其中一些与被膜包围的圆形、电子致密体密切相关。骨吸收速率增加，这通常与原发性甲状旁腺功能亢进最严重病例中的情况相当，这是由于破骨细胞活性和骨细胞性骨溶解共同作用所致。电镜显示，骨细胞陷窝的扩大和不规则并不总是由于骨细胞性骨溶解；同样的效果可能是由于陷窝壁钙化缺陷所致。讨论了在光镜和电镜下比较相同标本的优点。
