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目的分析慢性阻塞性肺疾病(COPD)患者骨质疏松的患病情况及发生骨质疏松的危险因素,以提高临床医生对COPD患者合并骨质疏松的重视程度。方法选择2013年2月至2014年12月在潞河医院呼吸科住院治疗的120例COPD患者及同期自愿接受骨密度测定的30例门诊体检人员(对照组)作为调查对象,进行骨密度测定、肺功能测定、血气分析和6 min步行试验,计算两组骨质疏松检出率及根据COPD综合评估分组各组中骨质疏松检出率,对发生骨质疏松的危险因素进行分析。用SPSS 13.0软件对数据进行t检验、χ2检验和logistic回归分析。结果 120例COPD患者中29例存在骨质疏松,48例存在骨量减少,骨质疏松检出率为24.2%,骨量减少检出率为40%;对照组中6例存在骨质疏松,7例存在骨量减少,骨质疏松检出率为20.0%,骨量减少检出率为23.3%,COPD组与对照组骨质疏松及骨量减少检出率差异无统计学意义(P>0.05)。COPD患者病情严重程度与骨质疏松与骨量减少检出率之间无明显关系。低体质指数和低第1秒用力呼气容积(FEV1)是发生骨质疏松与骨量减少的危险因素(OR值分别为0.71、0.13)。结论 COPD患者骨质疏松与骨量减少检出率较高,应引起临床医生的高度重视,在诊疗COPD的同时,更要注重合并症的诊治。
Objective To analyze the prevalence of osteoporosis and the risk factors for osteoporosis in patients with chronic obstructive pulmonary disease (COPD), and to improve the clinicians’ attention to osteoporosis in COPD patients. Methods A total of 120 COPD patients hospitalized in Respiratory Department of Luhe Hospital during the period from February 2013 to December 2014 and 30 outpatients (control group) randomly selected for bone mineral density measurement at the same period were selected as the subjects for the study. Pulmonary function tests, blood gas analysis and 6-min walking test were performed. The detection rate of osteoporosis and the detection rate of osteoporosis in each group were calculated according to the COPD comprehensive evaluation. The risk factors of osteoporosis were analyzed. Data were analyzed by t test, χ2 test and logistic regression with SPSS 13.0 software. Results Of the 120 COPD patients, 29 cases had osteoporosis, 48 cases had osteopenia, the detection rate of osteoporosis was 24.2% and the detection rate of osteopenia was 40%. Six cases in the control group had osteoporosis, Seven cases had osteopenia, the detection rate of osteoporosis was 20.0%, and the detection rate of osteopenia was 23.3%. There was no significant difference in the detection rate of osteoporosis and osteopenia between COPD group and control group (P> 0.05). There was no significant relationship between the severity of COPD and the prevalence of osteoporosis and osteopenia. Low body mass index and low 1 second forced expiratory volume (FEV1) were risk factors for osteoporosis and osteopenia (OR = 0.71 and 0.13, respectively). Conclusion The detection rate of osteoporosis and osteopenia in patients with COPD is high, which should be paid more attention to by clinicians. At the same time of diagnosis and treatment of COPD, more attention should be paid to the diagnosis and treatment of comorbidities.