老年慢性阻塞性肺疾病患者肺功能与骨密度和炎症因子的关系

Relationship of lung function with bone mineral density and inflammatory factors in elderly patients with chronic obstructive pulmonary disease

目的探讨老年慢性阻塞性肺疾病（COPD）患者肺功能与骨密度（BMD）、炎症因子的关系。方法将89例老年COPD患者按肺功能分级情况分为4组,Ⅰ级组10例,Ⅱ级组43例,Ⅲ级组29例,Ⅳ级组7例,测定各组股骨颈BMD、腰椎L_（2~4）BMD均值,检测各组炎症因子白介素-1（IL-1）、IL-8、IL-18和肿瘤坏死因子-α（TNF-α）的水平,并进行比较。结果患者股骨颈BMD随着COPD严重程度的增加而降低,不同肺功能级别组间差异具有统计学意义（P〈0.05）,腰椎L_（2~4）BMD差异无统计学意义（P〉0.05）;患者IL-1、IL-8、IL-18和TNF-α水平随着COPD严重程度的增加而升高,不同肺功能级别组间差异均有统计学意义（P〈0.05）。结论老年COPD患者肺功能越弱,炎症因子水平越高,股骨颈BMD越低。

Objective To investigate the relationship of lung function with bone mineral density（ BMD） and inflammatory factors in elderly patients with chronic obstructive pulmonary disease（ COPD）. Methods According to lung function,a total of 89 elderly patients with COPD were divided into gradeⅠgroup（ n = 10）,gradeⅡgroup（ n = 27）,grade Ⅲ group（ n = 29）,grade Ⅳ group（ n = 7）. BMD of 2-4 lumbar spine and femoral neck,the levels of interleukin-1（ IL-1）,interleukin-8（ IL-8）,interleukin-18（ IL-18） and tumor necrosis factor（ TNF-α） were detected and compared.Results With the increase of severity of COPD,the BMD of femoral neck was reduced,and the difference was significant among four groups（ P〈0. 05）. There was no statistical difference in BMD of 2-4 lumbar spine among four groups（ P〉0. 05）. With the increase of severity of COPD,the levels of IL-1,IL-8,IL-18 and TNF-α were increased,and the difference was significant among four groups（ P〈0. 05）. Conclusions The decrease of lung function might be related with BMD of femoral neck,and the levels of inflammatory factors in elderly patients with COPD.