心脏移植术后的骨质疏松症

Osteoporosis after cardiac transplantation

目的研究心脏移植后患者的骨质疏松症的发病情况。方法采用双能Ｘ线吸收扫描仪（ＤＸＡ）测定５３例心脏移植患者和２２例准备接受心脏移植患者的腰椎和股骨颈的骨矿密度（ＢＭＤ）。结果２２例未手术者的腰椎和股骨颈的ＢＭＤ基本正常，其Ｚ值均匀紧密地分布在０值周围。５３例心脏移植患者术后腰椎和股骨颈的ＢＭＤ下降，其Ｚ值出现明显的左移，８例患者出现腰椎骨质疏松，他们的股骨颈的ＢＭＤ也同时下降。术后患者的ＢＭＤ降低主要在术后２年以内。结论心脏移植术后患者可出现ＢＭＤ下降，严重者可出现骨质疏松症，其发病主要与术后长期使用肾上腺皮质激素和环孢素Ａ有密切关系。

Objective To study the prevalence of osteoporosis in patients undergoing cardiac transplantation.Methods By using dual energy X ray absorptiometry, bone mineral density(BMD) in lumbar spine and femoral neck was measured in 53 adult patients after cardiac transplantation and 22 patients prior to heart transplantation.Results Mean BMD in lumbar spine and femoral neck was roughly one standard deviation below the mean for age matched and sex matched subjects both for men and women. Eight patients( 15.1% ) had densitometric evidence of osteopenia defined as a Z score of - 2.0 SD or less. The mean BMD in lumbar spine and femoral neck was normal in 22 patients without undergoing cardiac transplantation. The most rapid drop in vertebral BMD occurred during the first 2 years following cardiac transplantation.Conclusion Osteopenia are common in the patients after cardiac transplantation, which might be related to the immunosuppressive therapy-glucocorticoid and cyclosporine A.