《肾病骨病》.ppt

肾性骨病
Renal Osteodystrophy(ROP)
精选ppt
肾性骨病的定义
分为狭义肾性骨病和广义肾性骨病。狭义肾性骨病是指慢性肾衰竭伴发代谢性骨病。广义肾性骨病是指和肾脏相关的疾病。
The ROP has
精选ppt
β2-微球蛋白淀粉样变。正常人每日产生β2-微球蛋白150-200毫克，当肾功能衰竭时β2-微球蛋白排泄减少在血中蓄积，并沉积于骨、关节及肌腱等处，引起骨的囊性损害，弥漫性脱钙及腕管综合症。
精选ppt
高转化性骨病的临床表现The clinical performance of high tumover bone disease
肌肉骨骼症状
骨痛和骨折，疼痛部位多见于腰背部、下肢等。表现为深部剧痛。
自发性肌腱撕裂，多发于四头肌、三头肌、跟腱、常发生于行走、下楼梯、和颠倒时
骨骼畸形和生长障碍，常见于小儿尿毒症患者
关节炎和关节周围炎，常表现为类似痛风性关节炎的红、肿、痛
Muscle and skeleton symptoms
Bone ache and the bone fracture.
Spontaneous tendon pulled.
Arthritis and periarthritis.
Skeletal deformity and growth retardation.
精选ppt
皮肤瘙痒，常未见皮疹，钙磷在皮肤沉积所致
皮肤溃疡和组织坏死，少见，后发于手指，足趾，股和踝部等
软组织钙化，包括血管、关节周围、内脏、皮下和眼睛等
内脏钙化，常发生于心肌和肺，如广泛的肺钙化引起肺纤维化
Itch of skin: often without rashes.
Dermal ulcer and tissue necrosis: seldom happen.
Soft tissue calcification
Internal organs calcification: often seen in the cardiac muscle and the lung.
精选ppt
高转化性骨病的诊断The diagnosis of the high tumover bone disease
实验室检查
低钙、高磷、高镁
骨形成的生物学标记物，血清碱性磷酸酶（TAB）总活力下 降
骨吸收的生物学标记物，血清胶原分解产物的酸性磷酸酶升高
血清PTH升高
血浆1，25（OH）2D3水平降低
Lab Examinations:
Low level of calcium, high level of phosphours, high level of magnesium;
The biological marker of the bone’s formation: the total vitality in serum alkaline phosphatase ( TAB) goes up;
The biological marker of the bone’s resorption: the level of the decomposition product of the serum collagen, ACPase, goes up;
The level of the PTH in the serum goes up;
The 1,25( OH)2D3 level lowers.
精选ppt
X线检查，对肾性骨病的敏感性不高，其特征常为骨吸收、侵蚀和硬化
骨密度的测定 是目前检测ROD可靠的理想的诊断方法
The X-ray checks shows little sensitive often has a character of bone resorption, erosion and sclerosis
The measurement of the bone density is a dependable and ideal diagnosis in ROP of current examination methods.
精选ppt
骨活检，是ROD惟一可靠的诊断依据,不仅可作出早期诊断,，成骨和破骨细胞数量活性增加，骨小梁周围纤维化
Bone biopsy is the only reliable diagnosis prove, which can not only make an earlier diagnosis, but also can give a corresponding treatment according to the