nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2006-10-4-62-65nefr-700Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSМИНЕРАЛЬНАЯ ПЛОТНОСТЬ КОСТЕЙ И ПАТОЛОГИЯ КЛАПАННОГО АППАРАТА СЕРДЦА У БОЛЬНЫХ НА ХРОНИЧЕСКОМ ГЕМОДИАЛИЗЕBONE MINERAL DENSITY AND PATHOLOGY OF THE HEART VALVE APPARATUS IN PATIENTS ON CHRONIC HEMODIALYSISВолковМ. М.VolkovM. M.

Кафедра пропедевтики внутренних болезней

ДобронравовВ. А.DobronravovV. A.

Кафедра пропедевтики внутренних болезней

КузнецовА. А.KuznetsovA. A.

Кафедра пропедевтики внутренних болезней

ШевяковаЕ. В.ShevyakovaE. V.

Кафедра пропедевтики внутренних болезней

БыстровЯ. Б.BystrovYa. B.

Кафедра пропедевтики внутренних болезней

Научно-исследовательский институт нефрологии Санкт-Петербургского государственного медицинского университета им. акад. И.П. ПавловаРоссия2006100420061046265Copyright © Волков М.М., Добронравов В.А., Кузнецов А.А., Шевякова Е.В., Быстров Я.Б., 20062006Волков М.М., Добронравов В.А., Кузнецов А.А., Шевякова Е.В., Быстров Я.Б.Volkov M.M., Dobronravov V.A., Kuznetsov A.A., Shevyakova E.V., Bystrov Y.B.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/700

ЦЕЛЬ РАБОТЫ. Определить характер связи между минеральной плотностью костей различных отделов скелета и патологией клапанов левой половины сердца у пациентов, получающих лечение хроническим гемодиализом. ПАЦИЕНТЫ И МЕТОДЫ. Двухэнергетическая рентгеновская абсорбциометрия (ДЭРА) трех отделов скелета с оценкой по Z-критерию выполнена у 58 больных (мужчин и женщин по 29 человек, средний возраст 49,8+13,3 лет), получающих хронический бикарбонатный гемодиализ (ГД) в среднем 74,3+70,1 мес. Кроме общепринятых клинических и лабораторных показателей всем пациентам выполнено УЗИ сердца, у 40 пациентов – суточное мониторирование ЭКГ и артериального давления (АД). РЕЗУЛЬТАТЫ. У пациентов с низкой минеральной плотностью костей (МПК) предплечья чаще наблюдались изменения митрального клапана (уплотнение и кальцификация; F=3,13, panova =0,035). ЗАКЛЮЧЕНИЕ. У пациентов с низкой МПК предплечья отмечаются более выраженные изменения митрального клапана, вероятно, из-за наличия общих факторов риска развития этих состояний: длительной гемодиализной терапии и гиперпаратиреоза.

THE AIM of the work was to determine the character of the relationship between the bone mineral density in different parts of the skeleton and pathology of the valves of the left half of the heart in patients treated by chronic hemodialysis. PATIENTS AND METHODS. Two-energy X-ray absorptiometry of 3 parts of the skeleton assessed by Z-criterion was performed in 58 patients (m/f – 29/29, mean age 49.8 ± 13.3 years) treated by chronic bicarbonate hemodialysis (HD) on average for 74.3 ± 70.1 months. In addition to general clinical and laboratory indices in all the patients USI was performed and in 40 patients - 24 hours’ monitoring of ECG and of arterial pressure. RESULTS. Patients with low bone mineral density (BMD) of the forearm more often had alterations of the mitral valve (infiltration and calcification; F=3.13, p anova = 0.035). CONCLUSION. More pronounced alterations of the mitral valve in patients with low BMD of the forearm appear to be due to general risk factors of the development of these conditions: prolonged hemodialysis therapy and hyperparathyroidism.

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The authors declare that there are no conflicts of interest present.