老年患者长期应用质子泵抑制剂对骨质疏松的影响研究

Effects of elderly patients with long-term use of proton pump inhibitors for osteoporosis

目的探讨老年患者长期应用质子泵抑制剂(PPI)对骨质疏松的影响。方法选取2011年1月至2015年1月期间该院收治的消化性溃疡患者150例为观察组,选取同期健康体检老年人150例为对照组。记录两组人群年龄、身高、体质量、PPI用药时间,采用骨密度测定仪检测患者治疗前后骨密度变化情况,包括腰椎L1~4、桡骨密度及尺骨骨密度。观察并记录观察组老年患者治疗前、治疗半年、治疗1年及2年后骨密度变化情况。结果治疗后,观察组患者胃泌素明显增多,血钙水平及骨密度明显下降,差异有统计学意义(P<0.05)。观察组老年患者腰椎、桡骨及尺骨骨密度明显低于对照组(P<0.05)。随着PPI用药时间的延长,老年患者腰椎、桡骨及尺骨骨密度均呈下降趋势。结论老年患者长期应用PPI会造成骨密度降低。

Objective To investigate the effect of long-term proton pump inhibitor on osteoporosis in elderly patients. Meth- ods A total of 150 patients with peptic ulcer treated in our hospital from January 2011 to January 2015 were selected as the obser- vation group. 150 healthy subjects were selected as the control group. The age, height, body weight and PPI time of the two groups were recorded. The changes of bone mineral density before and after treatment were measured by bone mineral density analyzer,in- cluding lumbar L1-4, radial density and ulna density. The changes of bone mineral density were observed and recorded in the obser- vation group before treatment,six months,1 year and 2 years after treatment. Results After treatment,the levels of gastrin were significantly increased in the observation group,and the serum calcium concentration and bone mineral density were significantly de- creased （P〈0.05）. The density of lumbar vertebrae,radius and ulna was significantly lower in observation group than those of con- trol group （P〈0.05）. With the prolongation of PPIs,lumbar vertebrae,radius and ulna density in observation group showed a de- creasing trend. Conclusion Long-term application of proton pump inhibitors in elderly patients can cause bone loss.