老年慢性阻塞性肺疾病合并骨质疏松血清白细胞介素-6及C反应蛋白相关研究

Correlation between serum interleukin-6 and C-reactive protein in elderly patients with chronic obstructive pulmonary disease and osteoporosis

目的探讨慢性阻塞性肺疾病(COPD)合并骨质疏松症患者骨密度(BMD)的变化与血清白细胞介素-6(IL-6)及C反应蛋白(CRP)的关系。方法选取稳定期COPD老年骨质疏松患者94例,所有对象应用双能X线吸收测定仪测定腰椎、股骨颈BMD。根据BMD将患者分为骨量正常组、骨量减少组和骨质疏松组。测定肺功能、血钙、磷及碱性磷酸酯酶(ALP)水平,并测定所有入选对象的IL-6及CRP水平。结果 COPD合并骨质疏松组和COPD合并骨量减少组的BMD较骨量正常组低,差异有统计学意义(P<0.01);各组血钙、血磷、ALP比较差异均无统计学意义(P>0.05);COPD合并骨质疏松组及COPD合并骨量减少组IL-6及CRP较COPD骨量正常组高,差异有统计学意义(P<0.01)。COPD患者的血清IL-6、CRP水平与BMD呈负相关(P<0.01)。结论COPD合并骨质疏松及骨量减少患者IL-6、CRP水平升高,且BMD减低与炎症因子IL-6、CRP的增高相关,COPD的全身炎症反应可能促进骨质疏松的发生。

Objective To investigate the change of bone mineral density(BMD)in patients with chronic obstructive pulmonary diseases(COPD)and osteoporosis and its correlation with serum inflammatory cytokines interleukin-6(IL-6)and C-reactive protein(CRP).Methods Ninety-four elderly patients with stable COPD and osteoporosis were included in the study.All patients underwent dual-energy X-ray absorptiometry to measure BMD in lumbar spine and femoral neck.According to BMD,the patients were divided into normal bone mass group,osteopenia group and osteoporosis group.The pulmonary function,serum calcium,serum phosphorus,and alkaline phosphatase(ALP)levels were measured,and the levels of IL-6 and CRP were determined.Results The BMD in the COPD+osteoporosis group and COPD+osteopenia group was lower than that in the normal bone mass group,with statistically sigificant difference(P<0.01).There were no statistically significant differences in the levels of serum calcium,serum phosphorus and ALP between the groups(P>0.05).The serum levels of IL-6 and CRP in the COPD+osteoporosis group and COPD+osteopenia group were higher than those in the COPD+normal bone mass group,with statistically significant differences(P<0.01).The serum levels of IL-6 and CRP were negatively correlated with BMD in patients with COPD(P<0.01).Conclusion The levels of IL-6 and CRP in patients with COPD,osteoporosis and osteopenia increase.The decrease of BMD is associated with the increased levels of inflammatory factors IL-6 and CRP.Systemic inflammatory responses to COPD may induce the occurrence of osteoporosis.