慢性阻塞性肺疾病与骨质疏松症关系的分析  

The relationship between chronic obstructive pulmonary diseases (COPD) and osteoporosis

作　　者：孙文萍[1] 薛延[2] 刘思金[2] 田巍[1] 张国英[1] 杨福荫[1] 范军[1] 

机构地区：[1]北京积水潭医院内科,邮政编码100035 [2]北京市创伤骨科研究所

出　　处：《北京医学》2001年第3期151-153,共3页Beijing Medical Journal

摘　　要：目的　探讨继发于慢性阻塞性肺疾病 (COPD)的骨质疏松症发生的影响因素。方法　测定老年COPD患者 30例及对照组 30例之血气、肺功能、腰椎 2～ 4(L2～ 4)和股骨颈 (Neck)、大转子 (Trach)、Ward's区骨密度(BMD)、骨矿含量 (BMC)以及骨代谢生化指标。结果　 COPD组较对照组髋部及腰椎 BMD、BMC明显降低。骨代谢生化指标尿羟脯氨酸与肌酐比值 (HOP/Cr)、血清甲状旁腺素 (PTH)、2 5 -羟维生素 D3[2 5 (OH) D3]增高明显 (P<0 .0 5 )。血清睾酮 (T)明显降低 (P<0 .0 5 )。 COPD组 Neck、L2 的 BMD及 Neck、L2 、L3、L2～ 4、的 BMC与氧分压(PO2 )呈显著相关 (P<0 .0 5 )。结论　继发于 COPD患者的骨质疏松症 ,骨吸收大于骨形成。缺氧、血清 PTH水平增高和 T水平降低是Objective To investigate the influence factors of secondary osteporosis caused COPD.Methods Thirty elderly with COPD patients and 30 controls were studied.Blood gas analysis,pulmonary function,bone mineral density (BMD) and bone mineral content (BMC) of lumbar vertebra (L 2～4 ),neck of femur (Neck),greater trochanter (Trach),Ward's triangle (Ward's),and bone metabolism biochemical markers were measured.Results The hip and lumbar vertebra's BMD and BMC in patients with COPD decreased obviously than that in the controls.The bone metabolism biochemical markers,the ratio of urinary hydroxyproline and creatinine (HOP/Cr),parathyroid hormone (PTH),25(OH)D 3 increased obviously ( P <0.05).Serum testosterone (T) decreased obviously ( P <0.05).In COPD group,Neck、BMD of L 2 and BMC of Neck、L 2、L 3、L 2～4 、 were significant correlation with partial pressure of PO 2 ( P <0.05).Conclusions The bone resorption in secondary osteoporosis caused by COPD was higher than bone formation.It is the key reaseon to lead to osteoporosis in the COPD that hypoxia,the increased serum level of PTH and the decreased serum level of T.

关 键 词：骨质疏松症 慢性阻塞性肺疾病 老年人 血气 肺功能 骨代谢生化指标 

分 类 号：R563[医药卫生—呼吸系统] R58[医药卫生—内科学]