不同分级慢性阻塞性肺疾病患者合并骨质疏松症的相关因素分析  

Risk factors of osteoporosis in patients with different grades of chronic obstructive pulmonary disease

作　　者：居旭 梁永杰[1] 汪进益[3] JU Xu;LIANG Yong-jie;WANG Jin-yi(Dept.of Respiratory Medicine,East Hospital,Tongji University,Shanghai 200120,China;Dept.of Respiratory Medicine,Jing an District Zhabei Central Hospital of Shanghai,Shanghai 200070,China;Dept.of Cardiovascular and Thoracic Surgery,East Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院呼吸科,上海200120 [2]上海市静安区闸北中心医院呼吸内科,上海200070 [3]同济大学附属东方医院心胸外科,上海200120

出　　处：《同济大学学报（医学版）》2018年第1期98-102,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨不同分级的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者发生骨量减少和骨质疏松(osteoporosis,OP)的危险因素。方法选取COPD临床稳定期患者63例(均为男性),采用双能X线骨密度测定仪测定患者左侧股骨颈的骨密度值,完成慢性阻塞性肺疾病评估测试(CAT)问卷,测定肺功能并按照慢性阻塞性肺疾病全球倡议指南进行分级。测定动脉血气、BMI,并记录年龄、吸烟量。选择63位年龄相匹配,有骨密度测定资料的健康男性作为对照组。结果 COPD 2级组和对照组骨量减少和骨质疏松发生率的差异无统计学意义(P>0.05),COPD 3级、4级组骨量减少和骨质疏松的发生率均高于对照组(P<0.05)。Logistic回归分析显示:低BMI、低第1s用力呼气容积占预计值百分比(FEV1%pred)和高CAT是COPD患者发生骨质疏松的危险因素(OR值分别为0.656、0.885、1.209,P均<0.01)。结论 COPD患者骨密度的降低与气流受限,低BMI、生活质量差有关。COPD 3级、4级患者是发生骨量减少及骨质疏松症的高危人群。Objective To analyze the risk factors of osteopenia and osteoporosis in patients with different grades of chronic obstructive pulmonary disease(COPD).Methods Sixty-three male patients with stable COPD were enrolled in the study.The bone mineral density of left femoral neck was measured by dual-energy X-ray absorptiometry(DXA).The quality of life of patients was assessed with COPD Assessment Test(CAT)questionnaire.The lung function was measured and graded according to Global Initiative for Chronic Obstructive Lung Disease(GOLD).Arterial blood gas and body mass index(BMI)were measured,and the age and smoking amount were recorded.Sixty-three healthy males were selected as control group.Results There was no significant difference in the incidence of osteopenia and osteoporosis between grade 2 COPD patients and controls.The incidence of osteopenia and osteoporosis in grades 3 and 4 patients was higher than that in the control group(P<0.05).Logistic regression analysis showed that low BMI,low FEV 1%pred and high CAT score were the risk factors of osteoporosis in COPD patients(OR=0.656,0.885,1.209,respectively;all P<0.01).Conclusion The decrease of bone mineral density in COPD patients is related to air flow limitation,low body mass index and poor quality of life.

关 键 词：慢性阻塞性肺疾病 骨质疏松症 慢性阻塞性肺疾病评估测试 相关性 危险因素 

分 类 号：R563[医药卫生—呼吸系统]