老年慢性阻塞性肺疾病患者继发骨质疏松症的影响因素.docVIP

老年慢性阻塞性肺疾病患者继发骨质疏松症的影响因素 [摘要] 目的 探讨老年慢性阻塞性肺疾病（COPD）患者继发骨质疏松症（OP）的影响因素。 方法 收集2015年1～8月本科收治的中、重度COPD住院患者50例为COPD组及同期老年健康对照组30例。检测并分析血气、肺功能、骨密度、骨代谢生化指标的变化。 结果 COPD组的左股骨颈、腰椎L1-4 BMD明显低于健康对照组（P 0.05，P 0.01）。与健康对照组比较，COPD组25（OH）D3明显降低（P 0.01），PTH明显升高（P 0.01），ALP略升高，Ca2+、P降低（P 0.05）。25（OH）D3水平与FEV1%预计值呈线性正相关（r 0.403，P 0.430）。BMD降低与PaO2水平密切相关（r 0.355，P 0.203），而与PaCO2和其他生化指标无明显关系。 结论 老年COPD发生OP时，骨吸收大于骨形成。缺氧、25（OH）D3水平降低是COPD继发OP的重要原因。 [关键词] 慢性阻塞性肺疾病；骨质疏松症；血气分析；骨密度 [中图分类号] R563 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0035-03 Impact factors of secondary osteoporosis in chronic obstructive pulmonary disease patients WANG Zhi-gang WANG Mei LIN Xue-jun ZHENG Hong-yan Department of Breath Internal Medicine，People′s Hospital Affiliated to Quanzhou Medical College，Quanzhou 362000，China [Abstract] Objective To explore the impact factors of secondary osteoporosis （OP） in patients with chronic obstructive pulmonary disease（COPD）. Methods 50 patients with medium and serve COPD from January to August 2015 of our hospital and 30 elderly health people were collected.The biochemical index changes of blood gas，pulmonary function，bone density and bone metabolism were detected and analyzed. Results The BMD of left femoral neck and lumbar vertebrae L1-4 in COPD group was obvious lower than that of control group respectively（P 0.05，P 0.01）.Compared with control group，the 25（OH）D3 in COPD group decreased obvious（P 0.01），but the PTH increased obvious（P 0.01），ALP increased a little and Ca2+，P decreased（P 0.05）.The level of 25（OH）D3 had positive relationship with FEV1% predicted value（r 0.403，P 0.430）.The decreased BMD had close relationship with PaO2 level（r 0.355，P 0.203），while had no obvious relationship with other biochemical index. Conclusion When elderly COPD patients with OP，the bone resorption is greater than bone formation.Hypoxia and 25（OH）D3 level decreases are the important reasons for secondary OP in COPD. [Key words] Chronic obstructive pulmonary disease；Osteoporosis；Blood gas analysis；B