哮喘-慢性阻塞性肺病重叠症(ACO)合并骨质疏松研究进展

The research progress in asthma-chronic obstructive pulmonary disease overlap (ACO) with osteoporosis

慢性阻塞性肺病(COPD)和骨质疏松在老年人中常见,且具有高度相关性。随着老龄化的发展,哮喘在老年人中的患病率也逐渐升高。哮喘-慢性阻塞性肺病重叠症(ACO)作为近几年新定义的气道疾病,具有哮喘及COPD双重病理特征,不仅严重影响中老年患者的呼吸功能,对患者全身各系统的危害也很大,常以多系统共病存在,骨质疏松及其脆性骨折均是常见的并发疾病。ACO通过多种机制(如肺功能、钙和维生素D水平、糖皮质激素应用、全身炎症免疫反应等)影响患者全身骨量及骨代谢,使骨密度及骨强度下降,增加罹患骨质疏松和脆性骨折的风险。ACO合并骨质疏松的临床治疗报道较少,尚缺乏统一标准及指南,还需要大量临床探索,以提高临床规范化诊治水平。

Chronic obstructive pulmonary disease(COPD) and osteoporosis are common and highly correlated in the elderly. With the development of aging, the prevalence of asthma in the elderly is also gradually increasing. Asthma-COPD overlap(ACO), as a newly defined airway disease in recent years, not only seriously affects the respiratory function of middle-aged and elderly patients, but also does great harm to whole body systems of the patients. Both osteoporosis and brittle fractures are the common concomitant diseases of ACO. ACO affects bone mass and bone metabolism through a variety of mechanisms such as lung function, calcium and vitamin D levels, glucocorticoid use, systemic inflammation, etc. Results ing in decreased bone mineral density and bone strength, therefore increasing the risk of osteoporosis and brittle fractures. There are few reports on the clinical treatment of ACO with osteoporosis. It is lack of established standards and guidelines. More clinical exploration should be carried out to improve the development of standardized diagnosis and treatment.