老年男性巨幼细胞性贫血患者骨密度研究

Study of bone mineral density in older male patients with megaloblastic anemia

目的探讨老年男性巨幼细胞性贫血（megaloblastic anemia,MA）患者骨密度的水平。方法选取2010年1月至2016年1月在解放军第309医院住院治疗的老年男性巨幼细胞性贫血患者40例为病例组,年龄62~86岁,平均（73.50±8.13）岁;选取同期该院体检中心接诊的健康老年男性40名为对照组,年龄63~85岁,平均（72.82±7.77）岁。收集身高、体重、体重指数等一般资料,采用双能X线骨密度测量仪对所有患者进行腰椎（L1-L4）和左侧髋部（Neck区）骨密度测量,测定所有患者空腹血谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酐（CRE）、尿素氮（BUN）及血清同型半胱氨酸（Hcy）、维生素B12、叶酸等生化指标,比较两组间上述指标的差异。结果巨幼细胞性贫血患者骨密度、叶酸、维生素B12均低于对照组,差异有统计学意义（P〈0.05）;而血清同型半胱氨酸（Hcy）却明显高于对照组,差异有统计学意义（P〈0.05）。两组间比较血清ALT、AST、CRE、BUN差异无统计学意义。结论合并有巨幼细胞性贫血的老年男性更容易发生骨质疏松,巨幼细胞性贫血可能是引起老年男性骨质疏松的危险因素之一。

Objective To evaluate the status of bone mineral density（BMD） in older male patients with megaloblastic anemia（MA）. Methods A total of 40 patients diagnosed as MA admitted to the Osteoporosis Department of the 309 Hospital from January 2010 to January 2016,aged 62 to 86（73. 50 ± 8. 13） years,were select as the research group. Another 40 healthy people undergone physical examination at the physical examination center during the same time period,with an average age of（72. 82 ±7. 77） years,were selected as the control group. BMD of L1-L4 and hip（femoral neck region） was measured using dual energy Xray absorptiometry（DXA,HOLOGIC,USA）. Height,weight,and serum AST,ALT,BUN,CRE,homocysteine（Hcy）,cyanocobalamin（Vit B12）,folic acid were measured in both groups. Results BMD and the levels of folic acid and Vit B12 were significantly lower in the MA group compared with the control group（P〈0. 05）,but the levels of Hcy were significantly higher than that of the control group（P〈0. 05）. Conclusion Older male patients with MA were more likely to suffer from osteoporosis,suggesting that MA may be a risk factor for osteoporosis in older male patients.