【摘要】 目的研究长期卧床老年人骨密度、骨代谢相关指标的变化特点。方法选取我院2015年6月前入院并接受长期卧床治疗的42例老年人患者,卧床时间≥6个月并记为观察组;选取同期来我院体检的40例健康老年人作为参照记为对照组。采用双能量X射线检测两组腰椎L2-4、右侧股骨颈(FN)、Ward’s三角处的骨密度(BMD)和骨代谢指标[骨源性碱性磷酸酶(BALP)、25-羟维生素D、N端骨钙素(N—MID)、甲状旁腺素(PTH)]等指标,记录观察组骨质疏松(OP)的发生情况。结果 BMD检测结果显示观察组腰椎L2-4、(0.83±0.25)g/cm2、FN(0.79±0.15)g/cm2、Ward’s三角处(0.71±0.11)g/cm2分别较对照组(1.12±0.17)g/cm2、(0.96±0.11)g/cm2、(0.86±0.25)g/cm2低,均差异显著(P<0.05);骨代谢检测结果显示两组骨形成指标BALP、N—MID并无显著差异(P>0.05),但观察组25-羟维生素(38.5±14.6)nmol/L相较对照组(51.2±18.7)nmol/L偏低,骨流失指标PTH(55.8±24.3)pg/ml较对照组(44.5±20.4)pg/ml高,均差异显著(P<0.05);观察组长期卧床患者OP发生率为35.71%(15/42)。结论长期卧床的老年患者易出现骨密度下降、骨代谢异常紊乱等骨功能衰退表现,维生素D缺乏、骨流失明显应引起临床足够重视,这对预防老年OP和改善住院生活质量具有重要意义。更多还原

【Abstract】 Objective: To study the features of changes of the indexes related to bone mineral density and bone metabolism in longterm bedridden elderly patients. Methods: Overall, 42 patients were admitted and treated in the Third people’s Hospital of Mianyang before June 2015, selected as test group(lying time ≥ 6 months) and 40 normal seniors as control group. The dual-energy X-ray was used to detect some indexes in two groups, such as the bone mineral densities(BMD) of lumbar L2-4, right femoral neck(FN), the bone density of Ward ’s triangle, bone metabolism[bone alkaline phosphatase(BALP), 25-hydroxy vitamin D, N-terminal osteocalcin(N-MID), parathyroid hormone(PTH)]. The occurrence of osteoporosis in test group was recorded. Results: The detection results showed that the BMD of lumbar L2-4(0.83±0.25) g/cm2, FN(0.79±0.15) g/cm2 and Ward ’s triangle(0.71±0.11) g/cm2 in the observation group were lower than those in the control group [(1.12±0.17) g/cm2,(0.96±0.11) g/cm2,(0.86±0.25) g/cm2 ](P < 0.05); Detection results of bone metabolism showed that there were no significant differences in bone formation indexes(BALP, N-MID) between the two groups(P>0.05). However, 25-hydroxyvitamin(38.5±14.6) nmol/L in the observation group was lower than that in the control group [(51.2±18.7) nmol/L] while bone loss index PTH(55.8±24.3) pg/ml was higher than that in the control group [(44.5±20.4) pg/ml](P < 0.05). The incidence of OP in long term bed ridden patients in the observation group was 35.71%(15/42).Conclusions: The seniors who are often in bed can easily occur to bone mineral density decline, bone metabolism disorder and other bone function regression. Vitamin D deficiency and bone loss clearness should pay more attention to clinician. It is of great significance for preventing osteoporosis and improving the quality of life in hospitalization.更多还原