老年男性慢性阻塞性肺疾病与骨质疏松生化指标及相关细胞因子的关系

Study of Bone Metabolism and Cytokine in Elderly Male Patients with Chronic Obstructive Pulmonary Disease

目的：探讨老年男性慢性阻塞性肺疾病患者骨密度、骨代谢指标及相关细胞因子的变化。方法：选取55例老年男性COPD患者作为COPD组,50例健康者为对照组,采用双能X线骨密度仪测量所有105例老年男性的腰椎、股骨近端骨密度。测定血液中骨形成指标骨钙素（BGP）和骨源性碱性磷酸酶（BALP）、骨吸收指标β-胶原特殊序列（β-CTx）和I型胶原交联氨基端肽（NTX）的含量;测定血液中细胞因子白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的水平。结果：COPD组的腰椎L2~L4、左股骨颈、大转子、股骨颈小梁三角的骨密度与对照组比较均明显降低,差异均有统计学意义（P〈0.05）。COPD组骨形成指标骨钙素与对照组相比降低不明显,而β-CTx略高于对照组,差异均无统计学意义（P〉0.05）;COPD组BALP水平明显低于对照组,而NTX高于对照组,差异均有统计学意义（P〈0.05）。COPD组的TNF-α明显高于对照组,差异有统计学意义（P〈0.05）,而IL-6略高于对照组,差异无统计学意义（P〉0.05）。结论：老年男性COPD患者骨密度低于同年龄健康对照组,更易发生骨质疏松,在COPD患者中IL-6、TNF-α等促进破骨细胞性因子增多,骨吸收增加,从而促进了骨质疏松症的发生。

Objective： To explore the change of bone mineral density （BMD）, bone metabolism biochemical markers and related cytokines in patients with COPD in aged men.Method： 55 cases of elderly male COPD patients as the COPD group were selected, and 50 age-matched healthy subjects as the control group.The bone mineral density （ BMD ） of lumbar vertebrae and proximal end of the femur were measured by dual energ3; X-ray absorptiometry.Serum BGP and BALP were used as markers for bone formation. 13 -CTx and NTX were measured as the bone absorption markers.Cytokines IL-6 and TNF- ct were measured.Result： In the COPD group, the BMD of lumbar vertebrae and proximal end of the femur were significantly lower, there