老年男性慢性阻塞性肺疾病与骨质疏松的关系

目的探索老年男性慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者骨密度(bone mineral density,BMD)水平及骨质疏松(osteoporosis,OP)发生率,进而探讨COPD与OP可能存在的联系。方法选取2013年1月至2017年9月期间入我院的60周岁以上共94名老年男性作为研究对象,并分为COPD组52名和对照组42名,利用双能X线骨密度仪测量不同部位的骨密度T值(腰椎TL2-4、股骨颈TNeck、髋部TTotal);肺通气功能仪测量肺通气指标值(FEV1%、FEV1/FVC%、VC%、MVV%)。计量资料采用独立样本t检验或曼-惠特尼U检验,计数资料采用χ2检验,多因素分析采用二分类Logistic回归分析。结果老年男性COPD患者的骨密度指标值(TNeck、TTotal)及肺通气各项指标值(FEV1%、FEV1/FVC%、VC%、MVV%)均显著低于对照组,差异具有统计学意义。老年男性COPD组与对照组的骨质疏松、骨量减少和骨量正常构成比分别为21.2%、55.8%、23.1%和9.5%、42.9%、47.6%,差异具有统计学意义。老年男性COPD的影响因素包括身高、体重、BMI指数、TNeck及FEV1/FVC%。结论老年男性COPD患者的股骨颈及髋部BMD显著低于对照组、骨质疏松的发生率显著高于对照组;老年男性患者股骨颈BMD值越高,COPD发生的风险越低。

Relationship between chronic obstructive pulmonary disease and osteoporosis in elderly males

Objective To explore bone mineral density (BMD) level and incidence of osteoporosis in elderly male patients with chronic obstructive pulmonary disease (COPD), and to explore the possible association between COPD and OP. Methods Ninety-four elderly male patients over 60 years old who had BMD and pulmonary function examined at the same time in our hospital from January 2013 to September 2017 were selected as the objectives. The BMD values (lumbar TL2-4, femoral neck TNeck, and hip TTotal) were measured using dual energy X-ray absorptiometry (DEXA). The pulmonary ventilation parameters (FEV1%, FEV1/FVC%, VC%, MVV%) were measured using a pulmonary function instrument. Independent samples t test or Mann Whitney U test was used to analyze the quantitative data. The qualitative data were analyzed by Chi-square test and multivariate analysis using logistic regression analysis. Results The BMD values (TNeck and TTotal) and pulmonary ventilation indexes (FEV1%, FEV1/FVC%, VC% and MVV%) were significantly lower in elderly male patients with COPD than those in the control groups, and the differences were statistically significant. The composition ratios of osteoporosis, osteopenia, and normal BMD in elderly male COPD group and the control group were 21.2%, 55.8%, 23.1% and 9.5%, 42.9%, 47.6%, respectively. The difference was statistically significant. The influencing factors of COPD in the elderly male patients were height, body weight, BMI index, TNeck, and FEV1/FVC%. Conclusion BMD of the femoral neck and hip in elderly male patients with COPD is significantly lower than that in the control group. The incidence of osteoporosis is significantly higher than that in the control group. The higher the BMD of the femoral neck, the lower the risk of COPD.