病毒性肝硬化中的代谢性骨病:一项前瞻性研究。

ISRN hepatology Pub Date : 2013-04-21 eCollection Date: 2013-01-01 DOI:10.1155/2013/276563
Rabia Goubraim, Nawal Kabbaj, Mouna Salihoun, Zakia Chaoui, M'Hamed Nya, Naima Amrani
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引用次数: 7

摘要

背景/目的。代谢性骨紊乱是公认的肝硬化肝外并发症。目的是报告其在病毒性肝硬化患者中的流行情况及其发展的相关因素。患者和方法。前瞻性纳入所有连续的病毒性肝硬化患者。对所有患者进行甲状旁腺激素、25-羟基维生素D、肝功能和磷钙试验。采用双能x线骨密度仪测定腰椎和全髋的骨密度。数据采用SPSS软件进行分析。结果。46例肝硬化患者合并丙型肝炎(87%)和乙型肝炎(13%)。Child-Pugh评分为A级的占87%,B级的占13%。37例患者骨密度降低,24例骨质减少,13例骨质疏松。95.6%的病例25-羟基维生素D含量降低。骨质疾病在体重指数低、肝病病程长、25-羟基维生素D水平低的老年患者中更为常见。这些因素都不是与骨骼疾病相关的独立因素。结论。我们的研究显示,在病毒性肝硬化患者中,代谢性骨疾病的患病率很高。因此,所有肝硬化患者都应系统地进行骨密度评估。
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Metabolic Bone Disease in Viral Cirrhosis: A Prospective Study.

Background/Aim. Metabolic Bone disorders are well-recognized extrahepatic complications of cirrhosis. The aim was to report their prevalence and the associated factors to their development in patients with viral cirrhosis. Patients and Methods. All consecutive patients with viral cirrhosis were prospectively enrolled. Parathyroid hormone, 25-hydroxyvitamin D, liver function, and phosphocalcic tests were measured in all patients. Bone mineral density was measured at the lumbar spine and total hip by dual-energy X-ray absorptiometry. Data were analyzed using SPSS software. Results. Forty-six cirrhotic patients were included with hepatitis C (87%) and hepatitis B (13%). The Child-Pugh score was grade A in 87% of cases and grade B in 13%. Thirty-seven patients had decreased bone mineral density with osteopenia in 24 patients and osteoporosis in 13 patients. Decreased 25-hydroxyvitamin D was found in 95.6% of cases. Bone disorders were significantly more frequent in old patients with low body mass index, long duration of liver disease, and low 25-hydroxyvitamin D level. None of these factors was an independent factor associated with bone disorders. Conclusion. Our study revealed a high prevalence of metabolic bone disorders among viral cirrhotic patients. Consequently, bone mineral density assessment should be performed systematically in all cirrhotic patients.

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