唑来膦酸对慢性阻塞性肺疾病患者骨质疏松症的临床疗效及对OPG/RANK/RANKL系统的影响  

Clinical Effect of Zoledronic Acid on Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease and Its Effect on OPG/RANK/RANKL System

作　　者：李硕 董明霞 张丽娜 LI Shuo;DONG Ming-xia;ZHANG Li-na(Department of Respiratory Nephrology,Kaifeng 155 Hospital,Kaifeng 475003,Henan Province,China)

机构地区：[1]开封一五五医院呼吸肾病内科,河南开封475003

出　　处：《罕少疾病杂志》2024年第9期115-117,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨唑来膦酸对慢性阻塞性肺疾病患者骨质疏松症的临床疗效及对OPG/RANK/RANKL系统的影响。方法 选取2019年5月~2022年9月在本院就诊的慢性阻塞性肺疾病合并骨质疏松症患者86例,在慢阻肺规范化治疗基础上,予以钙尔奇D,同时采用静脉注射的方式予以唑来膦酸注射液。统计患者治疗前后视觉模拟评分法(visual analogue scale,VAS)评分、骨密度、肺功能、骨代谢指标及相关性分析骨代谢指标关系。结果 治疗后VAS评分显著低于治疗前,腰椎BMD、股骨颈BMD均显著高于治疗前,差异均具有统计学意义(t=57.527,P<0.001;t=3.039,P=0.004;t=8.012,P<0.001)。治疗后肺功能FEV1、FEV1/FVC均优于治疗前,差异具有统计学意义(t=3.009,P=0.004;t=2.321,P=0.025)。治疗后骨代谢指标RANKL、RANKL/OPG、PINP、S-CTX、血磷均低于治疗前,差异均具有统计学意义(P<0.05),治疗前后OPG、血钙水平比较,差异无统计学意义(P>0.05)。相关性分析显示,OPG均与PINP、S-CTX呈负相关,但无显著差异(P>0.05),RANKL、RANKL/OPG均与PINP呈正相关,但无显著差异(P>0.05),但与S-CTX呈正相关,具有统计学意义(P<0.05)。结论 唑来膦酸用于治疗慢性阻塞性肺疾病合并骨质疏松症患者,可改善患者骨代谢,提高骨密度,其治疗机制与介导OPG/RANK/RANKL系统有关。Objective To investigate the clinical effect of zoledronic acid on osteoporosis in patients with chronic obstructive pulmonary disease and the effect on OPG/RANK/RANKL system.Methods A total of 86 patients with chronic obstructive pulmonary disease combined with osteoporosis admitted to our hospital from May 2019 to September 2022 were selected.On the basis of standardized treatment of COPD,calcini D was given and zoledronic acid injection was given intravenously.Visual Analogue Scale(VAS)scores,bone mineral density,lung function and bone metabolism indexes were analyzed before and after treatment,and their correlations were analyzed.Results VAS score after treatment was significantly lower than before treatment,BMD of lumbar spine and femoral neck were significantly higher than before treatment,the differences were statistically significant(t=57.527,P<0.001;t=3.039,P=0.004;t=8.012,P<0.001).Both FEV1 and FEV1/FVC were better after treatment than before,and the difference was statistically significant(t=3.009,P=0.004;t=2.321,P=0.025).After treatment,bone metabolism indexes RANKL,RANKL/OPG,PINP,S-CTX and blood phosphorus were all lower than before treatment,with statistical significance(P<0.05),while OPG and blood calcium levels before and after treatment had no statistical significance(P>0.05).Correlation analysis showed that OPG was negatively correlated with PINP and S-CTX,but there was no significant difference(P>0.05);RANKL and RANKL/OPG were positively correlated with PINP,but there was no significant difference(P>0.05),but they were positively correlated with S-CTX,with statistical significance(P<0.05).Conclusions Zoledronic acid can improve bone metabolism and bone mineral density in patients with chronic obstructive pulmonary disease complicated with osteoporosis,and its therapeutic mechanism is related to mediating OPG/RANK/RANKL system.

关 键 词：唑来膦酸 慢性阻塞性肺疾病 骨质疏松症 临床疗效 OPG/RANK/RANKL系统 

分 类 号：R563.9[医药卫生—呼吸系统] R589.5[医药卫生—内科学]