维持性血液透析患者脆性骨折及骨密度检查情况分析

目的：对维持性血液透析患者脆性骨折患病情况及骨密度（Bone mass density，BMD）检查情况进行横断面研究。方法：调查108例维持性血液透析患者脆性骨折患病情况，并记录年龄、性别、身高、体重、原发病、进入血液透析时间、女性绝经年龄等资料。所有患者均采用双能X线吸收仪（Dual energy X-ray absorptiometry，DEXA）进行腰椎、股骨BMD检测。用SPSS软件进行统计学分析。结果：骨折组年龄及进入透析时间明显高于未骨折组，体重及体重指数两组存在显著性差异（P〈0．05）。骨折组股骨及腰椎骨丢失率高于未骨折组，T-score明显低于未骨折组。骨折组股骨颈、大转子、Ward’s三角BMD明显低于未骨折组。腰椎BMD两组比较无显著性差异。结论：维持性血液透析患者脆性骨折患病率较高，髋部骨折多见，骨丢失率增加及骨密度降低是脆性骨折的重要危险因素，采用DEXA定期评价骨密度对于维持性血液透析患者脆性骨折防治具有重要临床意义。

An analysis about bone mineral density and fragility fractures in mainte-nance hemodialysis patients

Objective: A cross-sectional study on the bone mass density(BMD) characteristic and fragility fracture among the maintenance hemodialysis(MHD) patients.Methods: 108 MHD patients had been investigated about their fragility fractures,age,sex,stature,weight,primary disease,and had their lumbar and hip BMD detected by dual energy X-ray absorptiometry(DEXA).The data were statistically analyzed by SPSS software.Results: There were significant deviation on the age and the MHD years between the fragility fractures group and the no-fractures group(P<0.01),so as on the weight and the body mass index(P<0.05).Bone loss of lumbar and femoral in the fractured group was significantly more than the no-fractured group,and T-score of lumbar and femoral in the fractured group was significantly lower,BMD in neck,troch and Ward's region were significantly lower too.But there was no significant deviation in lumbar BMD.Conclusion: Fragility fracture frequently occur among the MHD patients,especially in femoral.Bone loss rate aggravation and BMD loss degrade are the important risk factors of fragility fracture.Regular BMD evaluation by DEXA about the MHD patients will be more helpful to the prevention and cure of the fragility fractures.