摘要
目的探讨阿法骨化醇对慢性阻塞性肺疾病患者骨代谢的影响。方法以240例骨量减少的C级、D级COPD患者为研究对象,随机分为对照组(A组)、阿法骨化醇组(B组)、阿法骨化醇联合碳酸钙组(C组)。随访1年,测定入组时、第6月及第12月患者骨密度、血清[25(OH)D]、Ca、P、PINP、β-CTX、PTH指标,比较3组患者不同时间点指标的差异,计算有关指标之间的相关性。结果3组患者入院时上述指标之间的差异均无统计学意义(P均>0.05)。3组患者在随访第6及第12月时,B组、C组患者骨密度、血清25(OH)D、Ca均明显高于A组,其余指标均低于A组(P均<0.05)。组内间比较,A组患者随访第12月骨密度、血清25(OH)D及Ca均低于入院时,其余指标均高于入院时(P均<0.05)。B、C两组患者随访第12月骨密度、血清25(OH)D及Ca均高于入院时及第6月,其余指标均低于入院时及第6月(P均<0.05)。三组患者入院时、第6月及第12月骨密度均与血清25(OH)D、Ca呈正相关(P均<0.05),而与血清P、PINP、β-CTX、PTH呈负相关(P均<0.05)。结论阿法骨化醇通过升高血清25(OH)D、Ca浓度增加慢性阻塞性肺疾病患者的骨密度。
Objective To investigate the effect of alfacalcidol soft capsules on bone metabolism in patients with chronic obstructive pulmonary disease.Methods In this study,240 patients with osteopenia grade C and D COPD were randomly divided into the control group(the group A),the alfacalcidol group(the group B),and the alfacalcidol combined with calcium carbonate group(the group C),80 patients in each group.All patients were followed up for 1 year.The indexes of bone mineral density,serum[25(OH)D],Ca,P,PINP,β-CTX and PTH in the patients were measured respectively at the time of enrollment,6 and 12 months.The differences of indexes at different time points among the 3 groups were compared,and the correlation between relevant indexes was calculated.Results There was no statistical significance in the above indexes among the three groups at admission(P>0.05).At the 6th and 12th month of follow-up,bone mineral density,serum 25(OH)D and Ca in the group B and C were significantly higher than those in the group A,while the remaining indexes were lower than those in the group A(all P<0.05).Within groups,bone mineral density,serum 25(OH)D and Ca in the group A at the 12th month of follow-up were lower than those at admission,while the remaining indexes were higher than those at admission(all P<0.05).The bone mineral density,serum 25(OH)D and Ca in the group B and group C at the 12th month of follow-up were higher than those at admission and the 6th month,while the remaining indexes were lower than those at admission and the 6th month(P<0.05).There was a positive correlation between BMD and serum 25(OH)D and Ca at admission,6 and 12 months of follow-up(P<0.05),but a negative correlation between BMD and serum P,PINP,β-CTX and PTH(P<0.05).Conclusion Alfacalcalcitol can increase the BMD of patients with chronic obstructive pulmonary disease by increasing serum 25(OH)D and serum Ca.
作者
张青
崔栋慧
鲁晓怡
赵云峰
ZHANG Qing;CUI Dong-hui;LU Xiao-yi;ZHAO Yun-feng(Department of Respiratory Disease,Punan Hospital of Pudong New Area,Shanghai 200125,China)
出处
《临床肺科杂志》
2021年第10期1497-1500,共4页
Journal of Clinical Pulmonary Medicine
基金
上海市浦东新区卫计委课题(青年项目)(No.PW2018B-12)
上海市浦东新区卫生系统领先人才培养计划(No.PWRl2017-01)
上海市浦东新区卫生系统重点专科培养计划(No.PWZzk2017-18)。
关键词
阿法骨化醇
慢性阻塞性肺疾病
骨代谢
alfacalcidol soft capsules
chronic obstructive pulmonary disease
bone metabolism
