Malluche H H, Ritz E, Lange H P, Arras D, Schoeppe W
Eur J Clin Invest. 1976 Jul 30;6(4):265-71. doi: 10.1111/j.1365-2362.1976.tb00520.x.
The change of bone mass during maintenance haemodialysis was studied in 20 patients. Iliac crest biopsies were obtained at a 9 - 16 months interval. Two biopsies were taken in order to give an independent estimate of the sampling error. 22 individuals in the same age group without skeletal disease who died from traffic accidents or from violent deaths were used as controls. Undecalcified sections of bone (Masson-Goldner-stain) were evaluated by micromorphometry. At the beginning of the study osteosclerosis (i.e. volumetric density of bone above x +/- 2 SD in control patients) was found in 14 out of 20 patients. Volumetric density of bone only increased in one of the patients during the observation period. A significant decrease of volumetric density of bone was found in 5 out of 20 patients. This could be attributed to prolonged immobilisation in two cases and to inadequate protein- and calorie-intake in two cases. No predisposing factor could be found in the fifth case. It is concluded that loss of spongy bone mass (osteopenia) is not an invariable result of haemodialysis.
对20例维持性血液透析患者的骨量变化进行了研究。每隔9 - 16个月取髂嵴活检组织。取两份活检组织以独立评估抽样误差。选取22名同年龄组无骨骼疾病、死于交通事故或暴力死亡的个体作为对照。采用微形态测量法对未脱钙骨切片（马松-戈德纳染色）进行评估。研究开始时，20例患者中有14例出现骨硬化（即对照患者骨体积密度高于x±2标准差）。在观察期内，仅1例患者的骨体积密度增加。20例患者中有5例骨体积密度显著降低。其中2例可归因于长期制动，2例归因于蛋白质和热量摄入不足。第5例未发现诱发因素。结论是，海绵骨量减少（骨质减少）并非血液透析的必然结果。
