慢性肾功能衰竭和肾移植患者血清骨钙蛋白测定及其意义

测定了６７例慢性肾功能衰竭患者（氮质血症１２例，尿毒症期５５例）和１３例肾移植患者血清骨钙蛋白（ｂｏｎｅ　Ｇｌａ　Ｐｒｏｔｅｉｎ，ＢＧＰ）水平。结果显示：尿毒症和氨质血症期患者的血清ＢＧＰ水平均显著升高，后者显著低于前者（Ｐ＜０．０５），但均明显高于正常组及肾移植组（Ｐ＜０．０１）。尿毒症进行各种透析对ＢＧＰ水平无明显影响，ＢＧＰ与甲状旁腺激素呈正相关（ｒ＝０．５４，Ｐ＜０．００１），与全血碱性磷酸酶、血清钙、磷和肌酐等无相关性。提示慢性肾功能衰竭时ＢＧＰ升高与肾脏清除率下降有关，也可能是肾性骨代谢紊乱的表现。

THE CLINICAL SIGNIFICANCE AND DETECTION OF SERUM BONE GLA-PROTEIN IN PATIENTS WITH CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION

Serum bone Gla protein (BGP) was measured in 67 patients with chronic renal failure (12 patients with azotemia, 55 patients with uremia) and 13 patients undergoing renal transplantation. Serum BGP levels were markedly increased in patients with uremia and patients with azotemia, the latter' serum BGP levels were much lower than the former's ones. But the serum BGP levels of the two groups of patients were obviously higher than those of the control group and the renal transplant group (P<0.01). The treatment of bemedialysis (HD) or Continuous ambulatory peritoneal dialyais (CAPD) had no effect on plasma levels of BGP in patients with chronic renal failure. serum BGP was peitively correlated with serum level of parathyloila hormone (PTH) (r=0. 54. P<0. 001). No significant correlations were found with serum levels of alkolinephosphatase,total calcium, phosphate and creatinine (P>0.01) These suggest that the increase in serum BGP in patients with chronic renal failure appears to be due to renal BGP retention, or may be a retsult of renal osteopathy.