老年男性慢性喘息性支气管炎患者吸入布地奈德福莫特罗粉与骨质疏松的相关性研究

Correlation between osteoporosis and inhaled budesonide formoterol powder in elderly male patients with chronic asthmatic bronchitis

目的 :探讨老年男性慢性喘息性支气管炎(chronic asthmatic bronchitis, CAB)患者吸入布地奈德福莫特罗粉与骨质疏松的相关性。方法:选择60例老年男性CAB患者为病例组,分别在吸入布地奈德福莫特罗粉治疗前、治疗1、2、3年测定骨密度(bone mineral density, BMD)、血清Ⅰ型前胶原羧基末端前肽(procollagen typeⅠN-terminal propeptide, PINP)、β-胶原降解产物(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)及骨钙素(bone glaprotein, BGP)水平,同时选择45例健康老年男性为对照组。结果:(1)病例组治疗1、2、3年骨量减少的比例逐步递增,其中以腰椎部骨量减少最明显。(2)病例组治疗2、3年股骨近端、Ward三角、腰椎部BMD值较治疗前明显降低(P<0.05),且降低幅度比对照组更明显。(3)病例组治疗2、3年的BGP、PINP水平较治疗前明显降低(P<0.05),β-CTX水平明显升高(P<0.05),且骨代谢标志物变化幅度比对照组更明显。结论:老年男性CAB患者长期吸入布地奈德福莫特罗粉对骨密度和骨代谢状态有一定影响。

Objective:To investigate the relationship between osteoporosis and inhaled budesonide formoterol powder in elderly male patients with chronic asthmatic bronchitis(CAB).Methods:Sixty elderly male patients with CAB were selected as the case group.Bone mineral density(BMD),serum procollagen typeⅠN-terminal propeptide(PINP),β-C-terminal telopeptide of typeⅠcollagen(β-CTX)and bone glaprotein(BGP)were measured before inhalation of budesonide formoterol powder and 1 year,2 years and 3 years after treatment respectively.Meanwhile 45 healthy elderly male were selected as the control group.Results:(1)The proportion of cases with osteopenia decreased gradually at 1 year,2 years and 3 years after treatment,and the lumbar spine bone mass loss was the most obvious.(2)The BMD of the proximal femur,Ward triangle and lumbar spine in the case group after 2 years and 3 years of treatment were significantly lower than those before treatment(P<0.05),and the extent of decrease was more obvious than that of the control group.(3)The levels of BGP and PINP in two years and three years after treatment in the case group were significantly lower than those before treatment(P<0.05),while the levels ofβ-CTX were significantly increased(P<0.05),and the changes of bone metabolism markers were more obvious than those in the control group.Conclusion:Long-term inhalation of formoterol powder in elderly male CAB patients has some effects on the bone mineral density and bone metabolism status.