老年人骨质疏松与动脉硬化的关系

Relationship between osteoporosis and atherosclerosis in elderly patients

目的 通过对骨密度与冠状动脉钙化积分、颈动脉内中膜厚度及斑块关系的分析 ,探讨骨质疏松与动脉硬化的关系。方法 对 6 6例老年冠心病、高血压或脑动脉硬化患者行双能X线骨密度仪测定腰椎、髋部、前臂的骨密度 ,螺旋CT检测冠状动脉钙化积分及冠状动脉总钙化积分 ,颈动脉超声检测颈动脉内中膜厚度及斑块 ,测定血甲状旁腺激素全段、骨钙素、血钙。据骨密度分骨质疏松组 (A组 ) ,非骨质疏松组 (B组 )。结果 A组患者的冠状动脉各分支钙化积分及冠状动脉总钙化积分、颈动脉内中膜厚度、颈动脉多发性硬斑发生率高于B组 (P <0 .0 1)。冠状动脉钙化积分、颈动脉内中膜厚度与甲状旁腺激素呈正相关 ,与骨钙素、血钙呈负相关 ,与各部位的骨密度呈负相关。结论 骨质疏松症与动脉硬化有密切的关系 ,骨质疏松时钙从骨中溶出增加 ,体循环中的钙可异常沉积在血管内膜中 ,造成血管壁动脉粥样硬化。

Objective To analyse the corelation of bone mineral density and coronary artery calcification score, carotid arterial intima-media thickness, plaque, and to explore the relationship between osteoporosis and arteriosclerosis in elderly patients. Methods The dural-energy X-ray absorptiometry scanner was applied to measure the bone mineral density of lumbar vertebrae, hip and forearm of 66 elderly patients with coronary heart diease or essential hypertension or brain atherosclerosis. The coronary artery calcification score and total calcification score were detected by spiral CT and calculated. Carotid arterial intima-media thickness, plaque were measured by ultrasound.The serum parathyroid hormone,parathormone, osteocalcin and calcium were assayed by different methods. The patients were divided into two groups according to the bone mineral density: group A (osteoporosis) and group B (non-osteoporosis). Results The coronary artery calcification score, total calcification score, carotid arterial intima-media thickness and the incidence of plaque of group A were significantly higher than those of group B(P< 0.01). The calcification score, carotid arterial intima-media thickness was positively correlated with osteocalcin, but negatively with serum calcium and bone mineral density.Conclusion Osteoporosis is closely related with atherosclerosis.In osteoporosis, calcium abnormally deposited in the tunica intima of the vessel,and induce atherosclerosis and calcification.