慢性心力衰竭患者股骨颈与腰椎的骨密度特点

Bone density characteristics of femoral neck and lumbar spine in patients with chronic heart failure

目的观察心力衰竭(HF)患者股骨颈与腰椎骨密度,探讨心力衰竭与骨密度之间的关系。方法选取211例慢性HF患者,根据射血分数(EF)分为EF保留的HF组(HFpEF组)、EF中间值的HF组(HFmrEF组)及EF降低的HF组(HFrEF组),同时设心功能正常的对照组;收集4组被检者性别、年龄及体重指数(BMI)等资料,检测B型钠尿肽前体(NT-pro BNP)及维生素D等血液生化指标,检测腰椎及股骨颈骨密度,分析HF患者年龄、血液生化指标与骨质疏松的相关性。结果与对照组相比,3组HF患者维生素D明显下降,差异有统计学意义(P<0.05);与对照组相比,3组患者股骨颈骨密度均降低,差异有统计学意义(P<0.05);在HF患者中,年龄、NT-pro BNP与骨质疏松呈正相关,BMI、维生素D与骨质疏松呈负相关,差异有统计学意义(P<0.05)。结论HF患者普遍存在骨密度降低,其中股骨颈骨密度降低更明显,心衰合并高龄、低BMI、维生素D缺乏更容易发生骨量流失。

Objective To investigate the relationship between heart failure(HF)and bone mineral density by analyzing bone density of femoral neck and lumbar vertebra in patients with heart failure.Methods A total of 211 chronic HF patients were selected and divided into EF preserved HF group(HFpEF),EF median HF group(HFmrEF),and EF reduced HF group(HFrEF group)based on ejection fraction(EF).A control group with normal cardiac function was also established.Recording general data of subjects[gender,age,body mass index(BMI)].Detecting blood biochemical indicators such as NT-pro BNP and vitamin D,detecting the bone density of lumbar vertebra and femoral neck,and analyzing the correlation between among age,blood biochemical indicators and osteoporosis in HF patients.Results All groups showed a significant decrease in vitamin D compared with the control group,the difference was statistically significant(P<0.05).The femoral neck bone density was decreased in all HF patients compared with control group,the difference was statistically significant(P<0.05).In HF patients,age and NT-pro BNP were positively correlated with osteoporosis,BMI,and vitamin D were negatively correlated with osteoporosis,difference was statistically significant(P<0.05).Conclusion Decreased bone density is prevalent in HF patients,with femoral neck bone density decreased the most obvious.HF combined with advanced age,low BMI,and vitamin D deficiency are more likely to cause bone mass loss.