Heaf J G, Pødenphant J, Gammelgaard B
Department of Nephrology P, Rigshospitalet, Copenhagen, Denmark.
Scand J Urol Nephrol. 1993;27(3):305-10. doi: 10.3109/00365599309180439.
In order to evaluate the reliability and representativity of iliac crest bone biopsy in uremic osteodystrophy, non-dynamic bone histomorphometry was performed post-mortem on the right and left iliac crests and the 3rd lumbar vertebra in 20 patients with chronic uremia. High (> 0.8) right-left correlation coefficients were found for bone volume, osteoid volume, osteoid surface, osteoid thickness, eroded surface, osteoclast surface and aluminium labelling intensity; moderate (0.7-0.8) for trabecular thickness, and low (< 0.7) for cortical thickness, porosity and aluminium bone concentration. High iliac crest-vertebra correlations were found for trabecular thickness, osteoid volume, osteoid surface, eroded surface, osteoclast surface and aluminium labelling intensity, and low correlations for bone volume, osteoid thickness and bone aluminium concentration. In conclusion, non-dynamic iliac trabecular bone indices are reliable variables and, with the possible exception of bone mass determination, indicative of systemic bone disease. Bone aluminium concentration and cortical bone indices are unreliable measures of uremic bone disease. These reservations apply to the diagnostic use of biopsy in individuals, but not necessarily its research use in groups of patients.
为评估髂嵴骨活检在尿毒症性骨营养不良中的可靠性和代表性，对20例慢性尿毒症患者的左右髂嵴及第三腰椎进行了死后非动态骨组织形态计量学检查。骨体积、类骨质体积、类骨质表面、类骨质厚度、侵蚀表面、破骨细胞表面及铝标记强度的左右相关系数较高（>0.8）；小梁厚度的相关系数中等（0.7 - 0.8），皮质厚度、孔隙率及骨铝浓度的相关系数较低（<0.7）。小梁厚度、类骨质体积、类骨质表面、侵蚀表面、破骨细胞表面及铝标记强度的髂嵴与椎体间相关性较高，而骨体积、类骨质厚度及骨铝浓度的相关性较低。总之，非动态髂骨小梁骨指标是可靠的变量，除骨量测定外，可指示全身性骨病。骨铝浓度及皮质骨指标对尿毒症性骨病的评估不可靠。这些保留意见适用于个体活检的诊断用途，但不一定适用于患者群体的研究用途。
