骨折联络服务干预慢性阻塞性肺疾病伴老年性骨质疏松症椎体再骨折的临床研究

Clinical Study of Fracture Liaison Service Intervention for Vertebral Refracture in Patients with Chronic Obstructive Pulmonary Disease and Senile Osteoporosis

目的观察骨折联络服务(FLS)干预慢性阻塞性肺疾病伴老年性骨质疏松症椎体再骨折的临床疗效。方法2017年6月至2020年6月收集广州医科大学附属第六医院收治的133例慢性阻塞性肺疾病合并老年性骨质疏松症椎体骨折患者,其中73例未接收“FLS”治疗模式,60例接受“FLS”治疗模式。观察两组患者骨密度改善情况、再次发生骨质疏松椎体骨折及肺功能改善情况。结果所有患者均随访12月以上。两组患者的一般资料,差异无统计学意义(P>0.05)。随访结束后,实施FLS组治疗后骨密度的及肺功能改善明显,差异有统计学意义(P<0.05)。未实施FLS组治疗前后骨密度的及肺功能比较,差异无统计学意义(P>0.05)。实施FLS组1年内再发骨质疏松椎体骨折风险低于未实施FLS组,差异有统计学意义(P<0.05)。结论FLS干预慢性阻塞性肺疾病伴老年性骨质疏松症可提高骨密度,改善慢性阻塞性肺疾病呼吸受限症状,降低骨质疏松椎体再发骨折风险。

Objective To observe the clinical effect of fracture liaison service(FLS)on vertebral refracture in patients with chronic obstructive pulmonary disease and senile osteoporosis.Methods From June 2017 to June 2020,133 patients with chronic obstructive pulmonary disease combined with senile osteoporosis vertebral fracture were collected from the Sixth Affiliated Hospital of Guangzhou Medical University.Among them,73 patients did not receive"FLS"treatment mode,and 60 patients received"FLS"treatment mode.The improvement of bone mineral density,the recurrence of osteoporosis vertebral fracture,and the improvement of lung function in the two groups were observed.Results All patients were followed up for more than 12 months.There was no significant difference in the general data between the two groups(P>0.05).After follow-up,bone mineral density and lung function were significantly improved in the FLS group,and the differences were statistically significant(P<0.05).There was no significant difference in bone mineral density and lung function before and after treatment in the group without FLS(P>0.05).The risk of recurrent osteoporotic vertebral fracture within 1 year in the FLS group was lower than that in the non-FLS group,and the difference was statistically significant(P<0.05).Conclusion FLS intervention in chronic obstructive pulmonary disease with senile osteoporosis can improve bone mineral density,improve respiratory restriction symptoms in chronic obstructive pulmonary disease,and reduce the risk of recurrent vertebral fractures in osteoporosis.