血透及腹透患者骨代谢指标比较与相关性分析

目的探讨血液透析（HD）及腹膜透析（PD）患者骨代谢血清生物化学指标的差异及其相关性。方法将患者按所采用的透析方式分为HD组及PD组，分别监测其血清中钙、磷、全段甲状旁腺激素（iPTH）、骨碱性磷酸酶（BALP）和抗酒石酸酸性磷酸酶5b（TRAP5b）的变化。结果两组间的血钙、血磷、iPTH及BALP水平无显著差异；HD组血清TRAP5b水平高于PD组（P〈0．05）；iPTH水平与BALP活性、TRAP5b活性呈正相关关系（r=0．466，r=0．745，P〈0．叭）。结论PD对血清TRAP5b活性的作用优于HD。将iPTH与BALP、TRAP5b结合起来综合分析能更全面了解骨组织的代谢情况，有益于肾性骨病的诊断和治疗。

Comparison on serum markers of bone turnover in patients on HD or PD and their correlation analysis

Objective To compare the biochemical markers in patients with end-stage renal disease on haemodialysis(HD)versus peritoneal dialysis(PD)and explore the correlation among the biochemical parameters.Methods The patients were randomized into two groups according to the dialysis mode.Serum calcium,phosphorus,intact parathyroid hormone(iPTH),bone alkaline phosphatase(BALP),and tartrate-resistant acid phosphatase 5b(TRAP5b)were determined during dialysis.Results The serum calcium,phosphorus,iPTH and BALP had no significant difference in the two groups.However,serum TRAP5b was significantly higher in HD group as compared with those of PD group(P<0.05).iPTH level was positively correlated with BALP and TRAP5b(r=0.466,r=0.745,P<0.01).Conclusion Peritoneal dialysis has powerful effect on serum TRAP5b.More comprehensive analysis of bone metabolism will benefit diagnosis and management for renal osteodystrophy,considering iPTH together with BAL and TRAP5b.