在评估末期脏病儿童的骨矿化状况时的脊柱骨评分:一个有前途的工具
Nanees Salem1, Ashraf Bakr2, Riham Eid3
1Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
European journal of pediatrics
|August 23, 2023
概括
脊椎骨评分 (TBS) 是评估慢性病 (CKD) 接受血液透析 (HD) 的儿童骨健康的宝贵工具. 儿科HD患者的TBS减少与骨折的更高发病率有关,这表明其有可能改善骨评估.
科学领域:
- 儿科脏病学 儿科脏病学
- 骨的新陈代谢 骨的新陈代谢
- 医疗成像医学成像
背景情况:
- 患有慢性病 (CKD) 的儿童经常出现骨质去矿化,因此需要进行骨健康评估以进行管理.
- 通过双能X射线吸收计 (DXA) 测量的面积骨矿物质密度 (aBMD) 广泛使用,但取决于大小,影响儿科CKD患者的准确性.
- 脊椎骨评分 (TBS) 为评估骨质量提供了一个潜在的替代方案,独立于患者的大小.
研究的目的:
- 评估TBS的实用性,从腰椎DXA扫描中得出的,在评估维护血液透析 (HD) 的儿童的骨状况.
- 将TBS测量与面积骨矿物密度 (aBMD) 进行比较,并评估它们与骨折等临床结果的相关性.
主要方法:
- 九十三名儿童 (9-18岁) 在维护性HD中接受了腰椎DXA扫描,以测量aBMD和TBS.
- 用442名健康对照的数据计算了aBMD (按时间年龄和身高年龄) 和TBS的Z分数.
- 进行了统计分析,以比较患者组之间的测量和对照,并评估与骨折史的相关性.
主要成果:
- 与健康对照组相比,患有HD的儿童的aBMD和TBS显著降低,无论身高状况如何.
- 在48%的男性和44%的HD女性中观察到退化的脊椎微型架构,TBS Z-score <-2 表示.
- 较低的TBS得分与儿科HD患者骨折史有显著的关联.
- 根据时间表年龄,TBS Z-score 与aBMD Z-score 显著相关,但不按身高年龄相关.
结论:
- 在维护性HD治疗的儿童中,TBS显著减少,并与骨折发生率增加有关.
- 作为一个大小独立的工具来评估儿科CKD患者骨微型架构,TBS显示出了前途.
- 对TBS在治疗决策和患者随访中的作用进行进一步研究是有必要的.
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