老年COPD合并2型糖尿病患者应用沙美特罗替卡松治疗对骨密度及血糖水平影响

Effects of SALMETEROL Fluticasone on bone mineral density and blood glucose level in elderly patients with COPD complicated with type 2 diabetes mellitus

目的研究应用沙美特罗替卡松治疗对慢性阻塞性肺疾病（COPD）合并2型糖尿病老年患者骨密度及血糖水平影响。方法选取2015年1月至2016年5月收治的118例沙美特罗替卡松治疗使用COPD合并2型糖尿病老年患者及同期接收的60例老年健康体检者为研究对象,老年COPD合并2型糖尿病患者根据沙美特罗替卡松服药累积时间进行分为≥6个月（71例）及〈6个月（47例）两组。检测并比较三组腰椎L3～4、股骨Ward＇s三角骨密度,空腹血糖（FPG）、餐后2 h血糖（2h PG）和糖化血红蛋白（HbA1c）水平。结果老年COPD合并2型糖尿病患者FPG、2h PG、HbA_1c水平均显著高于健康体检者（P〈0.05）,沙美特罗替卡松使用累计时间≥6个月的患者FPG、2h PG、HbA1c水平高于〈6个月患者,但是无统计学差异（P〉0.05）。老年COPD合并2型糖尿病患者腰椎L3～4、股骨Ward＇s三角均显著低于健康体检者（P〈0.05）,沙美特罗替卡松使用累计时间≥6个月的患者腰椎L3～4、股骨Ward＇s三角水平低于〈6个月患者,但是无统计学差异（P〉0.05）。结论对于COPD合并2型糖尿病老年患者,使用沙美特罗替卡松对骨密度、血糖水平无显著影响。

Objective To analyze the effect of SALMETEROL Fluticasone on bone mineral density and blood glucose level in elderly patients with chronic obstructive pulmonary disease（ COPD） complicated with type2 diabetes mellitus. Methods 118 elderly patients with chronic obstructive pulmonary disease（ COPD）complicated with type 2 diabetes mellitus treated with SALMETEROL Fluticasone in hospital from January 2015 to May 2016 and 60 healthy old persons were selected. According to the accumulated use time of SALMETEROL Fluticasone,the patients were divided into ≥6 months group with 71 cases and 6 months group with 47 cases.The bone mineral density of lumbar L3 ～ 4 and Ward ＇ s triangle,fasting blood glucose（ FPG）,postprandial 2H blood glucose（ 2h PG）,and glycosylated hemoglobin levels（ HbA1c） in cases of 3 groups were detected and compared. Results FPG,2h PG and Hb A1 c in elderly patients with COPD complicated with type 2 diabetes mellitus were significantly higher（ P〈0.05） than those in healthy persons. FPG,2h PG and Hb A1 c in patients of≥6 months group were higher than those of 6 months group,but the difference showed no statistical significance（ P〈0. 05）. The bone mineral density of lumbar L3 ～ 4 and Ward ＇ s triangle in elderly patients with COPD complicated with type 2 diabetes mellitus were significantly lower（ P〈0. 05） than those in healthy persons. The bone mineral density of lumbar L3 ～ 4 and Ward＇s triangle in patients of ≥6 months group lower than those of 6months group,but the difference showed no statistical significance（ P〉0. 05）. Conclusions SALMETEROL Fluticasone has no significant effect on bone density and blood glucose level in elderly patients with COPD complicated with type 2 diabetes mellitus.