老年帕金森病患者检测骨密度与血清维生素D的临床意义  

Clinical significance of the detection of hone mineral density and serum vitamin D levels in elderly patients with Parkinson’s disease

作　　者：仇福成[1] 孔祥增[1] 王文婷[1] 张赛[1] 张永志[1] 苑晓阳 顾平[1] Qiu Fucheng;Kong Xiangzeng;Wang Wenting;Zhung Sai;Zhung Yongzhi;Yuan Xiaoyung;Gu Ping(Department of Neurology,the First Hospital of Hebei Medical University,Hebei 050031,China)

机构地区：[1]河北医科大学第一医院神经科,石家庄050031

出　　处：《中华老年医学杂志》2020年第10期1151-1154,共4页Chinese Journal of Geriatrics

基　　金：2014年河北省卫生厅医学科学研究重点课题计划项目(ZD20140308)。

摘　　要：目的探讨老年帕金森病(PD)患者检测骨密度与血清维生素D的临床意义。方法回顾性病例对照研究,入选我院2016年6月至2018年12月收治的60例老年PD患者(PD组),同期按照年龄、性别相匹配的健康体检者60例为对照组。同时按照骨密度将PD患者分为骨质疏松组23例和非骨质疏松组37例。分别比较两组临床资料、骨密度和血清维生素D水平。并采用Logistic回归方程分析PD患者发生骨质疏松的相关因素。结果PD组患者骨质疏松、维生素D缺乏发生率均高于对照组[23例(38.3%)比13例(21.7%)、35例(58.3%)比21例(35.0%)均P<0.05],PD组骨密度、血清25-(OH)D水平低于对照组,(0.77±0.08)g/m^2比(0.83±0.09)g/m^2、(25.65±8.65)nmol/L比(39.80±10.74)nmol/L(t=4.381、8.439,均P<0.05)。PD患者中骨质疏松组年龄、病程、H-Y分级均高于非骨质疏松组,血清25-(OH)D水平低于非骨质疏松组(均P<0.05)。Spearman相关性分析结果显示,骨密度、25-(OH)D分别与年龄、病程、H-Y分期呈负相关,骨密度与25-(OH)D呈正相关(r=0.396,P<0.05)。多因素Logistic回归分析结果显示,维生素D缺乏是老年PD患者发生骨质疏松的独立危险因素(OR=2.332,95%CI:1.772〜8.224,P<0.01)。结论老年PD患者骨质疏松发生率高,且多存在维生素D缺乏,维生素D缺乏可能是骨质疏松发生的独立危险因素。Objective To investigate clinical significance of the detection of bone mineral density(BMD)and serum levels of vitamin D in elderly patients with Parkinson s disease(PD).Methods Sixty elderly patients with PD(the PD group)admitted in our hospital from June 2016 to December 2018 were enrolled in this retrospective study.And 60 healthy persorus confirmed by annual health check-up matched for age and sex during the same period were included as the control group.PD patients were divided into the osteoporosis group(n=23)and the non-osteoporosis group(n=37).The clinical data,bone mineral density and serum vitamin D level were compared between the two groups.Multivariate Logistic regression method was used to analyze related factors for osteoporosis in PD patients.Results The incidences of osteoporosis and vitamin D deficiency were higher in PD group than in control group[23 cases(38.3%)vs.13 cases(21.7%)、35 cases(58.3%)vs.21 cases(35.0%),all P<0.05].Bone mineral density and serum 25-(OH)D level were lower in PD group than in control group[(0.77±0.08)g/m^2 vs.(0.83±0.09)g/m^2,(25.65±8.65)nmol/L(39.80±10.74)nmol/L,t=4.381 and 8.439,P<0.05].The age,course of disease and H-Y grade were higher and serum level of 25-(OH)D was lower in the osteoporosis group than in the control group(F< 0.05).Spearman correlation analysis showed that BMD and 25-(OH)D were negatively correlated with age,course of disease and H-Y stage,respectively,and BMD was positively correlated with 25-(OH)D(r=0.396,P<0.05).Multivariate Logistic regression analysis showed that vitamin D deficiency was an independent risk factor for osteoporosis in elderly PD patients(OR=2.332,95%CI:1.772-8.224,P<0.01).Conclusions The incidence of osteoporosis is high in elderly PD patients,and vitamin D deficiency is often present.Vitamin D deficiency may be an independent risk factor for osteoporosis.

关 键 词：帕金森病 骨密度 骨质疏松 维生素D 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R580[医药卫生—临床医学]