COPD患者肺功能与骨密度及TRACP-5b的关系

目的探讨慢性阻塞性肺疾病(COPD)患者肺功能与骨密度、血清抗酒石酸酸性磷酸酶5b(TRACP-5b)水平及骨质疏松症的关系。方法 60岁以上男性COPD患者48例,根据一秒用力呼气容积(FEV1)分为两组:FEV1<80%为COPD中重度组28例(A组);FEV1>80%为COPD轻度组20例(B组);选择同期男性健康体检者40例作为对照(C组)。用双能X线吸收测定仪(DEXA)测定3组腰椎、股骨颈部骨密度(BMD),同时测定肺功能以及血清TRACP-5b水平,比较不同肺功能组患者骨密度、TRACP-5b的关系。结果 A组骨密度较B、C组降低(P<0.01);A组股骨颈及腰椎骨质疏松发生率高于B、C组(53.6%vs.25.0%、12.5%,60.7%vs.30.0%、20.0%)(P<0.05)。A组TRACP-5b值为(4.2±1.7)U/L,高于B和C组的(3.3±0.6)U/L和(2.5±0.8)U/L(P<0.05)。相关性分析显示,BMD与FEV1呈直线正相关(P<0.01)。TRACP-5b水平与FEV1水平及股骨颈、腰椎BMD呈负相关(P<0.01)。结论 60岁以上COPD患者骨密度降低;骨密度值与肺功能、体重指数(BMI)呈正相关,与血清TRACP-5b水平呈负相关。检测血清TRACP-5b对60岁以上COPD患者合并骨质疏松症的诊断有一定价值。

Correlation of lung function, bone mineral density and serum TRACP-5b in patients with COPD

Objective To investigate the correlation of lung function,bone mineral density(BMD) and serum tartrate-resistant acid phosphatase 5b(TRACP-5b) in men aged over sixty with chronic obstructive pulmonary disease(COPD).Methods Pulmonary function,BMD of lumbar vertibra and femoral neck,and serum TRACP-5b were determined and compared among three groups of A(28 cases with FEV1<80%),B(20 cases with FEV1>80%)and C(40 healthy people aged over sixty).The correlation of lung function,BMD and TRACP-5b was analyzed as well.Results BMD was lower in group A than that in groups of B and C(P<0.01).The osteoporosis incidence rate of femoral neck was higher in group A than that in groups of B and C(53.6% vs.25.0% and 12.5%)(P<0.05).So did that of lumbar vertibra(60.7% vs.30.0% and 20%)(P<0.05).Serum TRACP-5b level was significantly higher in group A was higher than that of groups of B and C [(4.2±1.7) U/L vs.(3.3±0.6) U/L and(2.5±0.8) U/L](P<0.01).Correlation analysis showed that BMD was positively correlated to FEV1(P<0.01) and serum TRACP-5b level was negatively correlated to FEV1 and BMD(P<0.01).Conclusion BMD of COPD patients over sixty is decreased.BMD is positively correlated to pulmonary function and BMI,and negatively correlated to serum level of TRACP-5b.Detection of serum TRACP-5b has a certain value in the diagnosis of osteoporosis in senile COPD patients.