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目的 研究肾移植患者术后的骨质疏松症发生情况 ,探讨有效的防治手段。方法 测定一组肾移植患者手术前后及采用α -D3 和降钙素等治疗后的骨密度 (BMD)改变和生化指标的变化。结果 ①肾移植患者术后 6～ 12月BMD较移植前明显下降 ,其腰椎骨密度Z值平均值低于 - 2 ;②采用α -D3 、降钙素及钙剂联合治疗后 ,其效果明显优于仅用α -D3 及钙剂治疗者。结论 ①肾移植后出现的骨质疏松症与术后应用皮质激素及环胞素A(CsA)有关 ,术前可能存在的继发性甲状旁腺功能亢进和肾性骨病加重了患者BMD的下降 ;②联合应用α -D3 、降钙素及钙剂治疗肾移植后骨质疏松症是安全有效的。
Objective To study the incidence of postoperative osteoporosis in renal transplant patients and to explore effective prevention and treatment measures. Methods The changes of bone mineral density (BMD) and biochemical parameters in a group of renal transplant recipients before and after operation and treatment with α -D3 and calcitonin were measured. Results ①The BMD of renal transplant recipients from June to December after operation was significantly lower than that before transplantation, and the average value of lumbar spine BMD was lower than -2. ② The combination of α -D3, calcitonin and calcium showed significant effect Better than only α -D3 and calcium treatment. Conclusions ① Osteoporosis after renal transplantation is related to the postoperative application of corticosteroids and cyclosporine A (CsA). The preoperative hyperparathyroidism and renal osteopathy may aggravate the BMD Decreased; ② combined application of α -D3, calcitonin and calcium treatment of post-transplant osteoporosis is safe and effective.