摘要
目的探讨老年男性COPD患者骨质疏松症的发生情况及相关影响因素。方法选择40例老年男性COPD患者为研究对象,30例年龄匹配的男性健康体检者为对照组。应用双能X线吸收测定仪测定腰椎、股骨近端骨密度(BMD)。并测定血清骨钙素、肺功能、动脉血气水平。结果COPD组腰椎、股骨近端(包括L1、L2、L3、L4及股骨颈、股骨颈小梁三角、大转子、股骨体)BMD分别为(0.815±0.157)g/cm2、(0.864±0.165)g/cm2、(0.958±0.195)g/cm2、(0.972±0.195)g/cm2?(0.739±0.110)g/cm2、(0.542±0.107)g/cm2、(0.619±0.103)g/cm2和(0.949±0.153)g/cm2,均较正常对照组显著降低(P均<0.01)。COPD组血清骨钙素较正常对照组显著升高[(5.67±1.59)ng/mL比(4.37±1.47)ng/mL,P<0.01],腰椎、股骨近端骨质疏松发生率较对照组显著升高(65%比40%,50%比20%,P均<0.05)。COPD组患者BMD在吸烟组较不吸烟组显著降低,使用激素组较未使用激素组显著降低(P<0.01或P<0.05)。COPD组腰椎、股骨近端BMD与PaO2、体重指数、FEV1%pred、FEV1/FVC呈显著正相关(P<0.01或P<0.05)。结论老年男性COPD患者BMD低于同年龄健康对照组,骨质疏松发生率增高。COPD继发骨质疏松症为高转换型。缺氧、肺功能指标、低体重指数、吸烟和使用糖皮质激素可能为影响COPD患者BMD的相关因素。
Objective To evaluate the incidence of osteoporosis and relevant factors in the elderly male patients with chronic obstructive pulmonary disease（COPD）. Methods Forty elderly male patients with COPD and thirty age-matched healthy subjects were enrolled. The bone mineral density （BMD） of lumbar vertebrae and proximal end of the femur were measured by dual energy X-ray absorptiometry. Serum levels of osteocalcin （BGP） and lung function were measured while blood-gas analysis of arterial blood was conducted. Results The BMD of lumbar vertebrae and proximal end of the femur（including lumbar 1 to 4, femoral neck, ward＇s triangle, trochanter and shaft） in the COPD group were significantly lower than those in the control subjects（ all P 〈 0. 01 ）. Serum BGP level in the COPD group was higher than that in the control group [ （ 5.67 ± 1.59） ng/mL vs （4. 37 ± 1.47 ） ng/mL, P 〈 0. 01 ）. The prevalence of osteoporosis among the COPD patients was significantly higher than that among the control subjects（65% vs 40% ,50% vs 20% , both P 〈 0. 05 ）. BMD in the COPD patients who had a history of smoking was significantly lower than those who did not smoke cigarettes （P 〈 0. 01 or P 〈 0. 05 ）. BMD in the COPD patients treated with glucocorticoid were significantly lower than those who were not receiving glucocorticoid therapy（ P 〈 0. 01 or P 〈 0. 05 ）. BMD was positively correlated with PaO2, BMI, FEV1% pred and FEV1/FVC（ P 〈 0. 01 or P 〈 0. 05 ）. Conclusions Compared with age-matched normal controls,BMD in elderly male COPD patients are significantly lower with increased osteoporosis risk.Osteoporosis induced by COPD is high change-over pattern. BMD in patients with COPD may be correlated with hypoxia,lung function, smoking,low body mass index and glucocorticoids therapy.
出处
《中国呼吸与危重监护杂志》
CAS
2008年第4期263-267,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
慢性阻塞性肺疾病
骨密度
骨钙素
Chronic obstructive pulmonary disease
Bone mineral density
Osteocalcin
