【摘要】 目的　通过观察老年男性慢性阻塞性肺疾病 (COPD)患者骨代谢的改变 ,了解老年男性COPD患者骨质疏松 (OP)的发生及有关影响因素。　方法　测定老年男性COPD患者 39例及对照组30例的骨代谢生化指标、腰椎和右股骨的骨密度 (BMD)、跟骨定量超声 (QUS)参数以及血气、肺功能。　结果　COPD组超声振幅衰减 (BUA)及超声声速 (SOS)分别为 (6 0 2± 7 0 )dB/MHz与 (132 8 4±4 1 5 )m/s,明显低于老年对照组 (6 6 5± 4 9)dB/Mhz与 (15 0 5 8± 2 6 9)m/s ;股骨颈、大转子、Ward’s三角及 2～ 4腰椎 (L2～ 4)BMD也较老年对照组分别降低 2 3%、2 1%、34%和 2 5 % ;骨吸收指标尿羟脯氨酸与肌酐比值 (HOP/Cr)、尿钙与肌酐比值 (Ca/Cr)、血清甲状旁腺素 (PTH)高于对照组 (P <0 0 5 ) ;血清睾酮 (T)明显降低 ,且与对照组差异有显著性 (P <0 0 5 )。　结论　老年男性COPD患者表现为骨吸收亢进和骨密度降低 ,缺氧是其重要病因之一。更多还原

【Abstract】 Objective To observe the alteration of bone metabolism and to study the pathogenesis of osteoporosis and factors in elderly patients with chronic obstructive pulmonary diseases (COPD). Methods The biochemical markers of bone metabolism, bone mineral density (BMD) of the lumbar spine and the right femur, parameters of calcaneal quantitative ultrasound(QUS), blood partial pressure and pulmonary functions in 39 male patients with COPD and 30 controls were measured. Results The broadband ultrasonic attenuation (BUA) and the speed of sound (SOS), BMD of the lumbar spines and the femur were significantly lower than that in control group. The biochemical markers of bone metabolism such as HOP/Cr, Ca/Cr, and PTH in the COPD group was significantly raised than that in control group〔(60 2±7 0)dB/MHz vs (66 5±4 9)dB/Mhz,(1 328 4±41 5)m/s vs (1 505 8±26 9)m/s,23% vs 34%,21% vs25%〕. The serum levels of Testosterone(T) reduced significantly ( P <0 05). Conclusions Bone resorption increased and BMD decreased in elderly male patients with COPD. Hypoxia is the important pathogenesis of osteoporosis in elderly male patients with COPD.更多还原