慢性阻塞性肺疾病患者血清25羟维生素D、骨密度、营养指标变化的相关临床研究  

Clinical study on changes of serum 25 hydroxyvitamin D,bone mineral density and nutritional indexes in patients with COPD

作　　者：杨波[1,2] 王勇生 杨万春 Yang Bo;Wang Yongsheng;Yang Wanchun(Bengbu Medical College,Bengbu 233003)

机构地区：[1]蚌埠医学院,安徽蚌埠233003 [2]合肥市第二人民医院呼吸内科,安徽合肥230011

出　　处：《中国现代医药杂志》2021年第10期11-15,共5页Modern Medicine Journal of China

基　　金：合肥市第二人民医院2019年度院级立项科研项目(编号:院科教[2019]45号)。

摘　　要：目的研究慢性阻塞性肺疾病(COPD)患者血清25羟维生素D、骨密度、营养指标的变化情况。方法选取2020年11月~2021年4月合肥市第二人民医院住院诊治的77例COPD患者作为COPD组,对照组为同时期在体检中心行健康体检的人员50例。所有对象检测肺功能、血清25羟维生素D、L_(2~4)骨密度及T值、股骨颈骨密度及T值、白蛋白(ALB)、前白蛋白(PA),分别比较COPD组与对照组以及COPD组不同肺功能患者间25羟维生素D、骨密度、ALB、PA的水平。结果COPD组患者25羟维生素D、FEV1/FVC、FEV1%、L_(2~4)和左右股骨颈的骨密度值及T值、体质指数、ALB以及PA均较对照组低(P<0.05),COPD组维生素D缺乏率及骨质疏松率高于对照组(P<0.05)。不同肺功能组间的患者25羟维生素D、左右股骨颈骨密度值及T值、ALB的差异具有统计学意义(P<0.05)。相关性分析显示,COPD组患者25羟维生素D、左右股骨颈骨密度值及T值、ALB与FEV1%呈正相关(P<0.05),L_(2~4)和左右股骨颈的骨密度值及T值、ALB与25羟维生素D呈正相关(P<0.05)。结论COPD患者易出现维生素D缺乏、骨质疏松及营养状况不佳,随着肺功能下降上述变化更为显著;COPD患者25羟维生素D与骨密度及ALB水平密切相关。Objective To investigate the changes of serum 25 hydroxyvitamin D,bone mineral density and nutritional indexes in patients with COPD.Methods 77 patients with COPD who were hospitalized and treated in Hefei Second People’s Hospital from Nov 2020 to Apr 2021 were selected as the research subjects.The control group included 50 healthy people who underwent physical examination in the physical examination center of our hospital during the same period.Lung function,serum 25 hydroxyvitamin D,lumbar 2~4 bone mineral density and T values,femoral neck bone mineral density and T values,albumin(ALB)and prealbumin(PA)were detected in all subjects,and the relationship among 25 hydroxyvitamin D,bone mineral density,ALB and PA in COPD group and control group as well as in COPD group with different lung function was compared.Results 25 hydroxyvitamin D,FEV1/FVC,FEV1%,bone mineral density and T values of lumbar spine 2~4 and left and right femoral neck,BMI,albumin and prealbumin in COPD group were lower than those in control group(P<0.05),while vitamin D deficiency rate and osteoporosis rate in COPD group were higher than those in control group(P<0.05).There were statistically significant differences in 25 hydroxyvitamin D,bone mineral density and T value of left and right femoral neck and albumin among different lung function groups(P<0.05).Correlation analysis showed that 25 hydroxyvitamin D,bone mineral density and T value of left and right femoral neck,albumin were positively correlated with FEV1%(P<0.05),bone mineral density and T values of lumbar spine 2~4 and left and right femoral neck,albumin were positively correlated with 25 hydroxyvitamin D in COPD group(P<0.05).Conclusion Patients with COPD are prone to vitamin D deficiency,osteoporosis and poor nutritional status,and the above changes are more significant as lung function deteriorates.In patients with COPD,25 hydroxyvitamin D is closely related to bone mineral density and ALB levels.

关 键 词：慢性阻塞性肺疾病 25羟维生素D 骨密度 肺功能 白蛋白 前白蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]