摘要
慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种常见的呼吸系统疾病,主要发生于中老年人,常具有多种肺外并发症,如心血管疾病、骨质疏松、糖尿病、代谢综合征等。COPD的致病因素有长期吸烟、缺少锻炼、有害气体的吸入等,糖皮质激素是主要的治疗方式,而糖皮质激素的长期使用会导致骨质疏松的发生。骨质疏松的特点是骨量低和骨组织微结构恶化,导致骨脆性增加,从而增加骨折风险。骨质疏松引起的骨折可能会增加COPD患者的发病率和死亡率,并导致患者肺功能进一步恶化。故COPD与骨质疏松关系密切,在一定程度上互为因果。COPD患者骨质疏松的高患病率被认为是由常见危险因素(如年龄较大和吸烟)以及COPD特定危险因素(如全身炎症、使用糖皮质激素以及维生素D缺乏等)造成的。目前,临床上针对COPD患者的治疗大多忽略了对其合并症骨质疏松的治疗,且COPD合并骨质疏松的病理机制仍有待进一步研究。因此,本文对COPD合并骨质疏松的发病机制、危险因素及治疗进行综述,以期为COPD合并骨质疏松的治疗提供新的方向。
Chronic obstructive pulmonary disease(COPD)is a common respiratory disease,which mainly occurs in the middle-aged and elderly people.It often has many extrapulmonary complications,such as cardiovascular disease,osteoporosis,diabetes,metabolic syndrome and so on.Long-term smoking,lack of exercise and inhalation of harmful gases are the main risk factors for COPD.Glucocorticoids are the main treatment method,and long-term use of glucocorticoids can lead to the occurrence of osteoporosis.The characteristics of osteoporosis are low bone mass and deterioration of bone tissue microstructure,leading to an increase in bone fragility,thereby increasing the risk of fracture.Fractures caused by osteoporosis may increase the incidence rate and mortality of COPD patients,and lead to further deterioration of lung function.Therefore,COPD is closely related to osteoporosis,and to some extent,they are mutually causal.The high incidence of osteoporosis in COPD patients is believed to be caused by common risk factors such as older age and smoking,as well as specific risk factors for COPD such as systemic inflammation,glucocorticoid use,and vitamin D deficiency.At present,the treatment of COPD patients in clinical practice mostly neglects the treatment of their combined osteoporosis,and the pathological mechanism of COPD combined osteoporosis still needs further research.Therefore,this paper reviews the pathogenesis,risk factors,and treatment of COPD combined with osteoporosis,in order to provide new directions for the treatment of COPD combined with osteoporosis patients.
作者
童成文
李胜
TONG Chengwen;LI Sheng(Department of Radiography Center,the People's Hospital of Shiyan,Hubei University of Medicine,Shiyan 442000,China)
出处
《生命的化学》
CAS
2023年第11期1773-1780,共8页
Chemistry of Life
关键词
慢性阻塞性肺疾病
骨质疏松
骨密度
chronic obstructive pulmonary disease
osteoporosis
bone density
