血清BUN、Scr、PTH和核素骨扫描在肾性骨营养不良中的应用

目的 评价血清BUN、Scr、PTH和^99Tcm-MDP核素骨扫描在肾性骨营养不良中的临床应用价值.方法 75例慢性肾功能衰竭的患者在一周内接受血清BUN、Scr、PTH检测和^99Tcm标记的亚甲基二磷酸盐（^99Tcm-MDP）核素骨扫描,对核素骨扫描图像上可能出现的代谢性骨病显像特征的数量进行评价,并采用三级评分法对各代谢性骨病的图像特征进行半定量分析.结果 75例受检者血清BUN平均为20.31 ±7.95 mmol/L;血清Scr平均为730.2±275.4μmol/L;69例受检者的血清PTH平均为1477.4±781.9 pg/mL（13.7 ～ 3306 pg/mL）.核素骨扫描图像上,30例患者具备5个图像特征,具备4个、3个和2个图像特征的受检者数量分别为32例、11例和2例;半定量分析结果显示75例患者的合计评分范围为4 ～10分.结论 血清BUN,Scr、PTH结合99Tcm-MDP核素骨扫描有助于为肾性骨营养不良患者的诊断、鉴别诊断和疗效评价等方面提供有价值的信息.

Application of Serum BUN,Scr, PTH and Radionuclide Bone Scan in Patients with Renal Osteodystrophy

Objective To evaluate the clinical value of serum BUN, Scr, PTH and ^99Tcm-MDP bone scan in patients with renal osteodystrophy. Methods 75 patients with chronic renal failure undertook the serum levels of BUN, Scr, PTH detection and ^99Tcm-MDP bone scan within one week. According to the results of bone scan, image characteristics related to metabolic bone disease were assessed based on visual analysis and semiquantitative score tool. Results Of all 75 patients, the average serum level of BUN was 20.31 ±7.95 mmol/L, serum level of Scr was 730.2 ± 275.4μmol/L, and the average serum level of PTH for 69 patients was 1477.4 ± 781.9 pg/mL. The total 30 patients had 5 metabolic image characteristics. The 32 patients, 11 patients and 2 patients had 4, 3, and 2 image characteristics, respectively. Semi- quantitative score result of 75 patients were ranged from 4 score to 10 score. Conclusion The serum levels of BUN, Scr and PTH combined with analysis of ^99Tcm-MDP bone scan in patients with chronic evaluation of renal osteodystrophy.