COPD患者肺功能与骨密度及TRACP-5b的关系

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

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。

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 FEV180%）,B（20 cases with FEV180%）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（P0.01）.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%）（P0.05）.So did that of lumbar vertibra（60.7% vs.30.0% and 20%）（P0.05）.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]（P0.01）.Correlation analysis showed that BMD was positively correlated to FEV1（P0.01） and serum TRACP-5b level was negatively correlated to FEV1 and BMD（P0.01）.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.