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目的探讨老年慢性阻塞性肺疾病（ＣＯＰＤ）患者骨质疏松的发生及有关影响因素。方法应用双能量Ｘ线吸光测定法测定ＣＯＰＤ组３９例患者及对照组１９例全身及局部的骨矿物含量，同时测定营养状态、血清钙、磷、碱性磷酸酶和肺功能。结果ＣＯＰＤ组体重、体重／理想体重％、上臂围、三头肌皮皱厚度、臂肌围、第２、３、４腰椎（Ｌ２～４）及左股骨Ｗａｒｄ＇ｓ区骨密度水平均显著低于对照组（Ｐ＜０．０５）。ＣＯＰＤ组Ｌ２～４和左股骨Ｗａｒｄ＇ｓ区骨质疏松发生率显著高于对照组（Ｐ＜０．０５）。Ｌ２～４和左股骨Ｗａｒｄ＇ｓ区骨密度均与体重、体重／理想体重％、上臂围、三头肌皮皱厚度、臂肌围呈显著正相关（Ｐ＜０．０５）。左股骨Ｗａｒｄ＇ｓ区骨密度与用力肺活量（ＦＶＣ％）、一秒钟用力呼气量（ＦＥＶ１％）及一秒率（ＦＥＶ１／ＦＶＣ％）均呈显著正相关（Ｐ＜０．０５）。结论老年ＣＯＰＤ组骨质疏松发生率高于同年龄对照组。营养状态、肺功能指标为影响ＣＯＰＤ患者骨密度的相关因素。
Objective To investigate the incidence and related factors of osteoporosis in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Whole body and local bone mineral contents in 39 patients with COPD and 19 controls were measured by dual-energy X-ray absorptiometry. Nutritional status, serum calcium, phosphorus, alkaline phosphatase and lung function were also measured. Results The body weight, body weight /% body weight, upper arm circumference, triceps skin fold thickness, arm muscle circumference, L2 ~ 4 lumbar spine (L2 ~ 4) and left femur Ward’s area were significantly lower In the control group (P <0.05). The incidence of osteoporosis in COPD group L2 ~ 4 and left femur Ward’s area was significantly higher than that in control group (P <0.05). The BMD of L2 ~ 4 and left femur Ward’s area were positively correlated with body weight, body weight / ideal body weight%, upper arm circumference, triceps skin fold thickness and extensor arm muscle circumference (P <0.05). There was a significant positive correlation between BMD of left femur Ward’s area and forced vital capacity (FVC%), forced expiratory volume per second (FEV1%) and FEV1 / FVC% (P <0.05). Conclusion The incidence of osteoporosis in elderly COPD group is higher than that of the same age control group. Nutritional status, lung function indicators for the impact of bone mineral density in COPD-related factors.