慢性饮酒、吸烟与骨质疏松的相关性研究

Chronic drinking and smoking and osteoporosis

目的 探讨长期大量慢性饮酒、吸烟等不良生活方式与骨质疏松的关系.方法 以乏力、腰背痛、双下肢酸困为主诉,且有长期大量慢性饮酒史、吸烟史,无其他慢性疾病史的年轻男性患者45例为观察对象,测定其血钙（Ca）、血磷（P）和血肌酐（Cr）、尿素氮（BUN）、血糖（Glu）、天门冬酸氨基转移酶（AST）、丙氨酸基转移酶（ALT）、血清碱性磷酸酶（ALP）、甲状腺功能、全段甲状旁腺激素（iPTH）、1,25-二羟维生素D3[1,25-（OH） 2D3]、双能X线骨密度仪测定腰椎L1-4及左侧股骨近段（包括颈、股骨颈上部、大粗隆）骨密度（BMD）,分析饮酒、吸烟对骨量的影响.以感冒发热就诊、年龄相当、无饮酒、吸烟史及慢性疾病史的45例男性为对照组.结果 观察组1,25（OH）2D3水平均降低,血钙水平偏低,血磷正常,碱性磷酸酶呈不同程度地升高,骨密度T值提示观察组27例骨质疏松,12例骨量减少,6例正常骨量；而对照组仅有6例为骨量减少,1例骨质疏松,38例为正常骨量,两组比较差异有统计学意义（P＜0.05）.结论 长期慢性大量饮酒吸烟影响骨量,甚至易导致骨质疏松.

Objective To explore the relationship of long time chronic drinking and smoking and osteoporosis.Methods Based on 45 cases of young men with chief complaint is lack of power,low back pain,double lower limbs acid trapped,and there was a large number of long-term chronic drinking and smoking history,detected Ca,P,Cr,Bun,Glu,AST,ALT,ALP,iPTH,1,25-（OH） 2 D3 using dual energy X-ray absorptiometry to measure the the lumbar L1-4 and on the left side of the bone stock recently（including neck,upper femoral neck,troch） bone mineral density （BMD）,and analyzed on the influence of the alcohol smoking bone.Included 45 cold fever young men patients in the same age the control group,and they have no drinking and smoking history and history of chronic diseases.Results In observation group,1,25 （OH）2 D3 were reduced,and had low blood calcium levels and normal blood phosphorus,and alkaline phosphatase was higher than in varying degrees.Bone mineral density T value prompted those 27 cases of osteoporosis,12 cases of bone loss,6 cases of osteoporosis in observation group.While the control group only 6 cases of bone loss,38 cases of normal bone mass.There were significant differences between the two groups（P ＜ 0.05）.Conclusion A large number of long-term chronic drinking and smoking can affect bone mass,and even lead to osteoporosis.