老年男性慢性阻塞性肺疾病骨密度及骨显像改变的初步研究

目的了解骨密度(BMD)改变与慢性阻塞性肺疾病(COPD)的关系,并探讨结合核素影像分析的诊断意义。方法对男性COPD患者47例和对照组30例分别以双能X线骨密度仪(DEXA)测定BMD值,并行放射性核素骨显像。结果老年COPD组的L2～4、股骨颈、Ward's区、大转子骨密度均较对照组明显减低,两组股骨颈、Ward's区骨质疏松的发生率比较有显著性差异(P<0.05,P<0.01)。26例患者全身骨显像呈弥漫性骨放射性分布减低。6例近期压缩性骨折患者见胸椎或腰椎异常放射性分布浓聚。结论老年COPD患者骨质疏松的发生率高于同龄对照组,应预防和治疗骨质疏松;骨显像可反映骨代谢的情况,对压缩性骨折的检出及新旧压缩性骨折的区分有帮助。

A study of bone mineral loss in elderly patients with chronic obstructive pulmonary disease

Objective To evaluate the change of bone mineral density (BMD) in elderly patients with chronic pulmonary disease (COPD),as well as to infer the relationship between the change of BMD and bone scintigraphy.Method 47 male patients with COPD and 30 control subjects were investigated.The BMD of lumbar vertebrae and left hip were measured by Dual Energy X ray Absorptiometry (DEXA) and whole body bone imaging were performed by single photon emission computed tomography (SPECT).Result The BMD at L2-4,femoral neck,Ward's triangle and troch in elderly male with COPD were lower than those in controls.The incidence of osteoporosis (OP) at femoral neck and Ward's triangle in patients with COPD were significantly higher than that in controls (P< 0.05 and P< 0.01,respectively).26 patients showed generally decreased skeletal uptake in scintigraphy.6 patients showed increased uptake in bone marrow with osteoporotic fractures.Conclusion The incidence of OP in aged patients with COPD was higher than in controls. Bone scintigraphy could be used to evaluate bone metabolism and showed decreased bone metabolism in many COPD patients.Bone scintigraphy also played a role in detecting osteoprotic fractures.