老年慢性阻塞性肺疾病合并骨质疏松症的临床分析

目的探讨老年慢性阻塞性肺疾病(COPD)合并骨质疏松症(OP)患者的相关影响因素。方法选择35例老年男性COPD合并OP患者为研究对象,32例肺功能正常的老年男性OP患者为对照组,应用双能X线吸收测定仪测定腰椎(L1～L4)、股骨骨密度(BMD),同时用肺功能仪测定肺功能,血气分析仪测定动脉血气分析。结果 COPD合并OP组腰椎、股骨BMD较对照组显著降低(P<0.01)。COPD合并OP患者中吸烟组BMD较非吸烟组显著降低(P<0.01),使用激素组BMD较无使用激素组显著降低(P<0.01)。COPD合并OP组腰椎、股骨BMD与氧分压(PaO2)、第一秒用力呼气容积占预计值百分比(FEV1%)、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)呈显著正相关(P<0.05)。结论老年男性COPD合并OP患者BMD值低于肺功能正常的OP患者,缺氧、肺功能指标、吸烟和使用糖皮质激素可能为影响COPD合并OP患者BMD的相关因素,低氧血症可能是老年COPD患者合并OP的主要危险因素,对老年COPD患者进行骨密度检查能及时发现骨质疏松。

Clinical Analysis of Older Male Chronic Obstructine Pulmonary Disease with Osteoporosis Patients

Objective To investigate the interrelated influence factor of Chronic Obstructine Pulmonary Disease（COPD） with Osteoporosis（OP） in older male patients.Methods Choose 35 older male COPD patients as research object.32 older male OP patients examined to be normal lung function as control group.The bone mineral density（BMD） of lumbar vertebrae（L1-L4） and femur were measured by dual energy X-ray absorptiometry.Lung fuction was measured by Spirometer.Arterial blood gas analysis was measured by Blood-gas Analyzer.Results The BMD of lumbar vertebrae and femur were significantly lower in the COPD with OP group than the OP group（P〈0.01）.The BMD of lumbar vertebrae and femur in the smoking group were significantly lower than the non-smoking group（P〈0.01）.The BMD in the COPD with OP group treated with glucocorticoid were significantly lower than those who were not receiving glucocorticoid therapy（P〈0.01）.The BMD in the COPD with OP group was postitively correlated with PaO2,FEV1%,FEV1/FVC（P〈0.05）.Conclusion The BMD in the COPD with OP group was lower than the OP group.Oxygen-poor,index of lung fuction,smoking,using glucocorticoid may be the interrelated influence factor of older male COPD with OP patients.Hyoxemia may be the major risk factor.BMD examine can discover OP in the older COPD patients promptly.